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TEXT-BOOK 


OF 


MEDICAL  JURISPRUDENCE 


AND 


TOXICOLOGY. 


By  JOHN  J.  REESE,  M.D., 

PROFESSOR    OF    MEDICAL    JURISPRUDENCE    AND    TOXICOLOGY     IN     THE    UNIVERSITY    OF 

PENNSYLVANIA;    VICE-PRESIDENT   OF  THE  MEDICAL  JURISPRUDENCE   SOCIETY   OF 

PHILADELPHIA;    PHYSICIAN     TO    ST.    JOSEPH'S    HOSPITAL;    MEMBER 

OF   THE    COLLEGE    OF   PHYSICIANS   OF    PHILADELPHIA; 

CORRESPONDING      MEMEER    OF    THE       NEW 

YORK  MEDICO-LEGAL  SOCIETY. 


PHILADELPHIA : 
P.    BLAKISTON,  SON  &  CO.: 

IOI2    WALNUT    STREET, 
1884. 

317 


Entered,  according  to  Act  of  Congress,  in  the  year  1SS4.  by 

P.  BLAKISTOX,  SOX  &  CO.. 

in  the  Office  of  the  Librarian  of  Congress,  at  Washington,  D.  C. 


•lJ7 


w 

loo 


PREFACE 


This  Text-book  has  been  written  more  particularly  to 
meet  the  wants  of  students  of  Legal  Medicine.  The  author 
is  aware  that  the  field  has  already  been  occupied  by  able 
and  popular  treatises  on  medical  jurisprudence,  well  known 
to  the  professions  of  medicine  and  law ;  but  an  experience 
of  over  twenty  years,  as  a  public  teacher  of  this  branch  of 
science,  has  convinced  him  that  students  in  both  these 
professions,  who  desire  to  acquire  a  knowledge  of  medical 
jurisprudence,  are  too  often  deterred  from  their  purpose  by 
being  confronted  by  the  ponderous  works  of  recognized 
masters,  extending  to  three,  and  even  six  large  octavo 
volumes. 

To  avoid  the  above  objection,  the  author  of  the  present 
work  has  endeavored  to  condense  in  a  handy  volume  all 
the  essentials  of  the  science,  and  to  present  the  various 
topics  in  a  simple  and  familiar  style,  giving  greater  promi- 
nence, of  course,  to  those  of  the  greatest  practical  im- 
portance. 

The  subject  of  Toxicology  occupies,  as  was  proper,  a 
considerable  space,  and  has  been  carefully  prepared;  special 
attention  being  bestowed  upon  the  most  important  poisons — 
such  as  Arsenic,  Strychnine,  Opium,  Prussic  Acid,  etc. 

The  chapter  on  Insanity  is  as  full  as  the  size  of  the 
volume  would  justify,  and  will   be  found,  it  is  hoped,  to 

iii 


iv  PREFACE. 

contain  all  the  essential  medico-legal  points  pertaining  to 
this  subject. 

The  author  has  not  hesitated  to  avail  himself  freely  of 
the  materials  so  abundantly  presented  in  the  elaborate  and 
classic  works  of  Casper,  Taylor,  Beck,  Wharton  and  Stille, 
Tidy,  Guy,  Tardieu,  and  others ;  always  desiring  to  give 
due  credit  to  the  authority  quoted,  and  usually  doing  so  at 
the  time ;  and  he  would  embrace  this  opportunity  to 
express  his  obligations  to  these  authorities.  He  is  sincerely 
desirous  to  encourage  an  increasing  interest  in  the  students 
of  both  medicine  and  law  for  that  most  important,  but  too- 
much  neglected,  subject — Forensic  Medicine;  and  he  would 
indulge  the  hope  that  the  present  treatise,  in  its  unpre- 
tentious size  and  style,  may  aid  in  so  doing. 
Philadelphia,  September,  iSSj.. 


TABLE  OF  CONTENTS. 


CHAPTER  I. 


Introduction.  PAGE 

Definition. — Importance    to    Students   of   Medicine    and    Law. — Order     of 
Proceeding    in     a    Medico-legal     Case. — The    Coroner's    Inquest. — The 
Criminal     Court.  —  Medical     Evidence.  —  Medical     Experts.  —  Dying 
Declarations.    ............       9 

CHAPTER   II. 
Phenomena  and  Signs  of  Death. 
Section  I. — Molecular  and    Somatic    Death. — The    Immediate   Cause   of 
Death  to  be  found  in  either  the  Heart,  Lungs   or  Brain. — Post-mortem 
Evidences  of  these. — The  "Signs  of  Death." — Cessation  of  Respiration 
and  Circulation. — Changes  in  the  Eyes. — Pallor  of  the  Body.  .         .         -25 
Section  II. — Signs  of  Death  continued. — Loss   of  Animal   Heat. — Post- 
mortem Caloricity. — Rigor  Mortis. — Post-mortem  Lividity,  or  Suggillation     32 
Section   III. — Signs   of    Death   continued. — Putrefaction. — External   and 
Internal     Signs. — Adipocere. — Mummification. — How     long     since    the 

Death? 41 

CHAPTER  III. 
Medico-legal  Investigations. — The  Post-mortem. 
Responsibility  involved. — Accuracy  and    Method  necessary. — Examination 
of  the  surroundings. — External   examination  of  the  Body. — Internal  ex- 
amination.— Details  of  the  Examination. — Measurements  and  Weights.— 

Notes 56 

CHAPTER  IV. 
Presumption  of  Death  and  of  Survivorship. 
Cases  involving  Presumption  of  Death  and  of  Survivorship. — French  Law 
of  Survivorship. — Probabilities  afforded  by  Age,  Sex,  and  Mode  of  Death.     65 
CHAPTER  V. 
Personal  Identity. 
Section   I. — Important   Medico-legal   bearings. — I.   Identification    of  the 
Living. — Personal    Appearance. — Peculiar   bodily    marks. — Remarkable 
Cases 69 


VI  TABLE    OF    CONTEXTS. 

PAGE 

Section  II. — II.  Identification  of  the  Dead. — Mutilated  Remains. — Identi- 
fication by  means  of  the  Skeleton,  as  to  Age,  Sex,  and  Stature. — Rules  of 
Proportion. — Fractures,  Deformities,  and  Callus. — Age   of  Bones. — Ex 

amination  of  Hairs  and  Fibres 76 

CHAPTER  VI. 
The  Causes  Producing  Violent  Death. 
Section  I. — Death  from  Wounds. — Definition  of  a  Wound. — Danger  of. — 
Examination  of  the  Body. — Absence  of  external   marks  of  violence. — 
Wounds   made   before  and   after  death. — Hemorrhage. — Ecchymoses. — 
Classification. — Homicidal,  Suicidal  and  Accidental  Wounds.   .         .         .92 
Section   II. — Gunshot   Wounds. — Differ  from  other    wounds. — Deflection 
of  the  Ball. — Wounds  made  by  Shot,  Wadding  and  Powder. — Wounds  of 

the  Head,  Xeck,  Spine,  Chest  and  Abdomen 107 

CHAPTER  VII. 
Examination  of  Blood  Stains. 
Importance  of  their  identification. — Three  methods  of  identifying. — 1.  The 
Chemical  Tests. — 2.  The  Microscopic  Test. — 3.  The  Spectroscopic  Test. 

—Blood  Crystals 121 

CHAPTER  VIII. 
Burns  and  Scalds. 
Definition. — Classification. — Symptoms.  —  Cause    of    Death. — Post-mortem 
appearances. — Burns  made  before  and  after  death. — Accidental,  Suicidal 
and  Homicidal  Burns. — Spontaneous  Combustion.     .         .         .         .         .   134 

CHAPTER    IX. 
Death  from  Different  Forms  of  Asphyxia. 
Section  I. — Death  from  Suffocation. — Accidental,  Suicidal  and  Homicidal 

Suffocation. — Post-mortem  signs, 143 

Section  II. — Death  by  Strangulation. — Modes  of  Strangulation. — External 
signs. — Internal  lesions. — Accidental,  Suicidal   and  Homicidal   Strangu- 
lation.— Mark  of  the  Cord,        .........   146 

Section  III. — Death  by  Hanging. — Cause  of  Death. — Post-mortem  appear- 
ances.— Cord  marks. — Generally  suicidal,         .         .         .         .         .         .   151 

Section  IV. — Death  by  Drowning. — Mode  of  Death. — Time  required. — 
Signs  of  Death,  external  and  internal. — Accidental,  Suicidal  and  Homi- 
cidal Drowning,       .  .  .  .  .  .  .  .         .  .  .156 

CHAPTER   X. 

Death  by  Lightning. 

Medico-legal  relations. — Mode  of  Death. — Post-mortem  signs,      .         .         .  166 


TABLE    OF    CONTENTS.  Vll 

PAGE 

CHAPTER  XI. 
Death  from  Heat  and  Cold. 
Diverse    effects    of   Heat    upon    the    body. — Postmortem    appearances. — 
Effects  of  Cold. — Post  mortem  signs, 170 

CHAPTER  XII. 
Death  by   Starvation. 

Accidental,  Homicidal  and  Suicidal  Starvation. — Pretended  cases  of  volun- 
tary starvation. — Symptoms,  and  Post-mortem  signs. — Medico-legal  rela- 
tions,         175 

CHAPTER  XIII. 
Death  from  Poisoning. — Toxicology. 

Section  I. — Definition  of  a  Poison. — Effects. — Proofs  of  Absorption. — 
Subsequent  disposition  of  the  Poison. — Elimination. — Cause  of  Death. — 
Circumstances  modifying  their  action. — Antagonism  of  Poisons,         .         .178 

Section  II. — Evidences  of  Poisoning. —  1.  Evidences  from  Symptoms. — 2. 
From  post-mortem  lesions. — 3.  Chemical  Analysis. — Post-mortem  Imbi- 
bition of  Poisons. — Rules  in  performing  a  toxicological  analysis. — 4. 
Physiological  experiments. — 5.  Circumstantial  Evidence. — Medico-legal 
conclusions. — Classification,      .         .         .         .         .         .         .         .         .186 

CHAPTER  XIV. 
Poisoning   by   the    Mineral   Acids. 
Certain    common    symptoms. —  Post-mortem     appearances. — Treatment. — 
Chemical  analysis. — Toxicological  examination    for  the    different   Acids,  202 
CHAPTER  XV. 
Poisoning  by  the  Alkalies  and  their  Salts. 
Section  I. — Potassa,  Soda,  and  Ammonia. — Similarity  of  effects. — Symp- 
toms.— Fatal    Dose. — Treatment. — Post-mortem   appearances. — Chemical 
analysis.  ............  215 

Section  II. — Poisoning  by  the  Alkaline  and  Earthy  Salts. — Nitrate  of 
Potassium. — Bitartrate  of  Potassium. — Sulphate  of  Potassium. — Alum. — 
Chlorinated  Potassium  and  Sodium. — Salts  of  Barium.      ....  220 

CHAPTER  XVI. 
Irritants  Possessing  Remote  Specific  Properties. 
Section  I. — Poisoning  by  Phosphorus. — Symptoms. — Fatal  Dose. — Treat- 
ment.— Morbid    appearances. — Diagnosis.  —  Chemical    analysis. —  Amor- 
phous Phosphorus.  ...........  224 

Section  II. — Poisoning  by  Iodine,  Bromine,  and  Chlorine.  .         .         .  234 


Vlll  TABLE    OF    CONTENTS. 

PAGE 

CHAPTER    XVII. 
Poisoning  by  Arsenic. 

Metallic  Arsenic. — Arsenious  Acid. — Properties. — Symptoms.  — Chronic 
Poisoning. —  Fatal  Dose. — Treatment. — Post-mortem  signs. — Chemical 
analysis. — Toxicological  examination. — Other  Preparations  of  Arsenic.     .  238 

CHAPTER  XVIII. 
Poisoning  by  Antimony  (Tartar  Emetic). 
Properties  of  Tartar  Emetic. — Symptoms. — Fatal  Dose. — Post-mortem  ap- 
pearances.— Slow  Poisoning. — Chemical  analysis. — Toxicological  exami- 
nation  -  262 

CHAPTER  XIX. 
Poisoning  by  Mercury  (Corrosive  Sublimate). 

Corrosive  Sublimate. — Properties. — Symptoms. — Post-mortem  appearances. 
— Fatal  Dose. — Antidotes. — Chemical  analysis. — Toxicological  examina- 
tion.— Salivation 273 

CHAPTER  XX. 
Poisoning  by  Lead. 
Frequency  of  Chronic   Poisoning. — Acetate  of  Lead. — Symptoms. — Treat- 
ment.— Post-mortem  appearances. — Painters'  Colic. — Lead  Palsy. — Toxi- 
cological examination.     ..........  285 

CHAPTER  XXI. 
Poisoning  by  Copper. 
Accidental  Poisoning. — Salts  of  Copper. — Fatal  Dose. — Treatment. — Morbid 
appearances. — Chemical  analysis. — Toxicological  examination.         .         .  294 

CHAPTER  XXII. 
Poisoning  by  Zinc,  Bismuth,  Tin,  Iron  and  Chromium. 

Section  I. — Poisoning  by  Zinc. 301 

Section  II. — Poisoning  by  Bismuth 305 

on  III. — Poisoning  by  Tin,  Iron  and  Chromium 306 

CHAPTER  XXIII. 
Vegetable  and  Animal  Irritants. 
Section  I. — Poisoning  by  Oxalic  Acid.— Sources  of  the  Acid  in  Nature. — 
Symptoms. — Fatal  Dose. — Treatment. — Morbid  appearances. — Chemical 
analysis. — Toxicological  examination. — Binoxalate  of  Potassium.       .         .  308 
Section  II. — Poisoning  by  Carbolic  Acid. 315 


TABLE   OF  CONTENTS.  X 

PAGE 

Section  III. — Poisoning  by  Croton  Oil,  Elaterium,  Castor  Oil  Beans, 
Colchicum  and  Savin 317 

Section  IV. — Poisoning  by  the  Hellebores. — Veratria. — Yellow  Jessamine. 
— Poisonous  Mushrooms. 320 

CHAPTER  XXIV. 
Animal  Irritants. 

Poisoning  by  Cantharides. — Poisonous  Animal  Food. — Sausage  Poison. — 
Trichinosis. — Cheese  Poison. — Poisonous  Fish. — Putrescent  Food. — Pois- 
oned Flesh 325 

CHAPTER  XXV. 
Class  II.     Neurotic  Poisons. 
Section  I. — Narcotics. — Poisoning  by  Opium. — Nature   of  Opium. — Pois- 
onous  Symptoms. — Fatal    Period    and    Dose. — Treatment. — Morphia. — 
Properties. — Tests. — Meconic  Acid. — Tests. — Toxicological  examination.  330 
Section    II. — Poisoning  by   Alcohol. — Acute   Alcoholism. — Symptoms. — 
Post-mortem  lesions. — Chemical  analysis. — Detection  in  the  Tissues.  .  341 

CHAPTER  XXVI. 

2.     Anaesthetics. 

Poisoning  by  Ether,  Chloroform,  and  Chloral  Hydrate.          ....  345 

CHAPTER  XXVII. 
Spinal  Neurotics. — Poisoning  by  Nux  Vomica. — Strychnia. 
Nux  Vomica. — Strychnia. — Effects. — Fatal   Dose. — Treatment. — Post-mor- 
tem   lesions. — Diagnosis. —  Chemical    analysis. —  Interferences. —  Physio- 
logical Test. — Toxicological  examination. 351 

CHAPTER  XXVIII. 
Cerebro-spinal  Neurotics. — (1)  Deliriants. 
Section  I. — Poisoning  by  Belladonna.— Symptoms. — Atropia. — Fatal  Dose. 
— Treatment. — Post-mortem    appearances. — Chemical  analysis. — Toxico- 
logical examination.  ..........  373 

Section  II. — Poisoning  by  Stramonium,  Hyoscyamus  and  Solanum.     .         .  376 

CHAPTER  XXIX. 
2.     Depressants. 
Section  I. — Poisoning   by   Tobacco   and  Lobelia. — Effects  of  Tobacco. — 
Post-mortem     lesions.  —  Nicotina. —  Properties. —  Chemical    reactions.  — 
Toxicological  examination. — Lobelia 380 


X  TABLE    OF    CONTENTS. 

PAGE 

Section  II. — Poisoning  by  Hemlock — Conia. — Symptoms. — Post-mortem 
appearances. — Conia. — Chemical  reactions. — Toxicological  examination. 
— Other  poisonous  Hemlocks. 3S6 

Section  III. — Poisoning  by  Aconite  and  Calabar  Bean. — Properties  of  the 
Plant. — Effects. —  Post-mortem  appearances. —  Aconitine. — Fatal  Dose. 
— Treatment. — Chemical  analysis. — Toxicological  examination. — Calabar 
Bean. — Eserine.       ...........  390 

CHAPTER  XXX. 
(3)     Asthenics. 

Section  I. — Poisoning  by  Hydrocyanic  Acid. — Natural  Occurrence  in 
Vegetables. — Pure  and  Officinal  Acids. — Symptoms. — Fatal  Period  ai  1 
Dose. — Treatment. —  Post-mortem  appearances. — Tests. —  Toxicological 
examination. — Cyanide  of  Potassium. — Oil  of  Bitter  Almonds. — Cherry- 
laurel  Water. — Xitro-Benzole. 397 

Section  II. — Poisoning  by  Digitalis. — Symptoms. — Post-mortem  lesions. 
— Fatal  Dose. — Digitaline. — Chemical  analysis. — Toxicological  exami- 
nation.— Case  of  De  la  Pomerais. — Poisoning  by  Cocculus  Indicus.  .         .  409 

CHAPTER  XXXI. 
The  Alkaloids  of  Putrefaction. — Ptomaines. 


ur" 


^es  v.-he: 

.    "-  ■  .icert 

nr  .  jjead, 

aninal  Abort.^n,  or  !•;. 
Definition. — Frc  rUency  of  Abortion  from   Natural 
Fcetus  has  been  desf^yed. — Signs  afforded  by 
F<:etus. — Means  <  ;d, 


-permit- 
i.u.ant. — Was  it  born  alive  ?■ 
a  Live  Birth   '     '  Lungs. — The 


TEXT-BOOK 


MEDICAL  JURISPRUDENCE 

AND 

TOXICOLOGY. 


CHAPTER  I. 

DEFINITION. — IMPORTANCE  TO  STUDENTS  OF  MEDICINE  AND  LAW.— 
ORDER  OF  PROCEEDING  IN  A  MEDICO-LEGAL  C\SE. — THE  CORO- 
NER'S INQUEST. — THE  CRIMINAL  COURT. — MEDICAL  EVIDENCE.— 
MEDICAL   EXPERTS. — DYING    DECLARATIONS. 

Medical  Jurisprudence,  or  Legal  or  Forensic  Medicine, 
as  it  is  sometimes  named,  may  be  defined  to  be  the  science 
which  applies  the  knowledge  of  Medicine  to  the  require- 
ments of  Law.  To  aid  in  the  discovery  of  truth,  which  is 
the  great  purpose  of  the  Law,  every  department  of  human 
knowledge  should  be  made  to  contribute,  and  Medicine 
among  the  rest.  When  certain  cases  are  presented  for  legal 
decision,  affecting  the  life  or  property  of  an  individual, 
and  these  cases  require  for  their  proper  elucidation  an 
appeal  to  medical  knowledge,  they  are  termed  medico-legal 
cases,  and  the  science  on  which  they  are  based  is  named 
Medical  Jurisprudence. 

It  should  require  no  argument  to  show  the  importance 
of  the  knowledge  of  this  science  to  the  student  and  prac- 
titioner of  both  the  professions  of  medicine  and  law.  The 
former  cannot  entirely  evade  its  claims,  although  he  may 

9 


10  MEDICAL   JURISPRUDENCE. 

seek  to  do  so,  since  the  very  nature  of  his  profession, 
together  with  his  assumed  public  position  as  an  accredited 
physician,  renders  him  liable  at  any  moment  to  be  con- 
fronted with  a  case  involving  the  intricate  questions  of 
homicidal,  suicidal,  or  accidental  death ;  of  infanticide ; 
of  criminal  abortion;  of  rape ;  of  drowning,  and  of  numer- 
ous other  similar  cases,  all  of  which,  when  they  become 
the  subjects  of  legal  investigation,  must  necessarily  depend 
for  their  proper  elucidation,  chiefly,  if  not  solely,  upon  the 
physician  who  had  previously  given  his  professional  at- 
tendance in  the  case,  and  who  must  subsequently  give  his 
evidence  before  the  court  and  jury.  How  important,  then, 
that  the  practitioner  of  medicine,  even  though  he  may  have 
no  special  leaning  towards  legal  medicine,  should  become 
acquainted  at  least  with  the  general  principles  and  leading 
facts  of  this  science.  A  proper  regard,  both  for  his  own 
professional  reputation  and  the  general  interests  of  the 
community,  should  constrain  him  not  to  neglect  so  import- 
ant and  practical  a  branch  of  knowledge.  And  as  regards 
the  profession  of  the  law,  it  is  difficult  to  understand  how 
a  criminal  cause  of  any  kind  can  be  satisfactorily  conducted 
without  some  knowledge  o(  medical  jurisprudence,  inas- 
much as  criminal  law  is  indissolubly  connected  with  legal 
medicine.  It  is  much  to  be  regretted  that  many  of  the 
present  generation  of  lawyers  in  this  country,  graduate  in 
their  profession  without  the  slightest  knowledge  of  medical 
jurisprudence.  Indeed,  strange  as  it  may  appear,  it  is 
entirely  ignored  in  some  of  our  law  schools,  whilst  in 
others,  although  professedly  taught,  it  is  not  made  obliga- 
tory upon  the  student,  and  therefore  is  virtually  disregarded. 
The  consequence  of  such  neglect  must  be  either,  that 
criminal  law  is  entirely  abandoned  by  many  distinguished 
practitioners,  causing  such  cases  to  fall  into  the  hands  of 


RELATION    OF    MEDICINE    TO    LAW.  11 

inferior  persons,  who  are  not  always  the  best  qualified  to 
conduct  them ;  or  else,  when  a  really  important  criminal 
case  is  undertaken,  the  lawyer  finds  himself  compelled  to 
cram  for  the  occasion,  and  is  subjected  to  no  little  annoy- 
ance, and  loss  of  time,  in  preparing  for  the  impending  trial. 
In  truth,  in  such  cases  he  is  necessarily  obliged  to  depend 
almost  exclusively  upon  his  medical  witnesses,  both  as  to  the 
general  mode  of  developing  his  case,  and  especially  as  to  the 
manner  of  questioning  the  expert  witnesses  on  either  side. 

The  superficial  observer  is  often  surprised  at  the  intimate 
relationship  subsisting  between  the  two  great  sciences  of 
medicine  and  law.  As  has  just  been  shown,  numerous 
cases  brought  before  a  court  and  jury  can  only  be  settled 
by  an  appeal  to  medical  knowledge ;  sometimes  it  is  to  one 
department  of  medicine,  and  sometimes  to  another ;  and  it 
not  infrequently  happens  that  several  branches  of  medical 
science  may  be  simultaneously  called  into  requisition,  in 
order  to  aid  the  law  in  arriving  at  a  proper  decision.  For  ex- 
ample,— is  the  case  one  of  suspected  homicide,  where  a  dead 
body  has  been  discovered  under  suspicious  circumstances  ? 
Who  but  the  skillful  anatomist  and  pathologist,  by  a  carefully 
conducted  autopsy,  can  shed  the  requisite  light  upon  it  ?  Is 
it  a  case  of  alleged  rape,  or  criminal  abortion,  or  infanticide? 
Who  so  well  qualified  to  conduct  the  investigation  as  the 
well  trained  obstetrician  ?  Or  is  it  a  case  involving  the  dark 
suspicion  of  criminal  poisoning  ?  Who  shall  impart  the 
necessary  information  upon  which  may  hang  suspended 
the  life  or  death  of  the  accused,  save  he  who  is  thoroughly 
acquainted  with  the  mysteries  of  toxicology  ?  Thus  it  may 
happen  that,  in  a  multitude  of  cases,  the  well  instructed  prac- 
titioner of  medicine,  when  called  upon  to  act  the  part  of  the 
legal  physician,  may  be  obliged  to  bring  into  requisition  all 
the  various  departments  of  his  science. 


12  MEDICAL    JURISPRUDENCE. 

It  is,  perhaps,  as  a  medical  witness,  that  medico-legal 
knowledge  is  of  the  most  important  service  to  the  physician. 
After  he  has  accomplished  the  investigation  of  the  case  be- 
fore him  by  a  carefully  conducted  autopsy,  or  by  a  critical 
toxicological  examination,  with  perhaps  the  aid  of  micros- 
copy, and  by  other  methods  of  scientific  research,  there  yet 
remains  the  all-essential  duty  of  giving  the  results  of  his 
investigations  to  the  court  and  jury,  in  the  form  of  evidence; 
and  to  be  prepared  to  do  this  in  the  proper  manner,  consti- 
tutes the  chief  acquirement  of  the  medical  jurist. 

The  Coroner  s  Inquest. — The  first  public  duty  imposed 
upon  the  legal  physician  is  to  testify  before  the  Coroner's 
Inquest.  In  all  civilized  countries  a  special  officer,  named 
the  coroner,  is  appointed  to  investigate  the  unknown,  or 
unexplained  causes  of  sudden  death,  whenever  this  occurs 
under  suspicious  circumstances.  For  example,  a  dead  body 
is  discovered  on  the  highway  or  in  some  sequestered  spot, 
with,  or  without  marks  of  external  violence,  or  it  may  have 
been  dragged  out  of  the  river;  the  body  of  a  new-born 
child  has  been  found  in  a  well  or  cesspool,  or  discovered 
floating  in  the  water;  a  stranger  is  discovered,  in  the  morn- 
ing, dead  in  bed,  at  some  hotel,  far  distant  from  his  home; 
or  a  person  in  apparent  sound  health  suddenly  drops  dead 
in  the  street,  or  in  his  room.  In  all  these,  and  analo- 
gous cases,  the  law  very  wisely  provides  that  a  careful  in- 
vestigation shall  be  instituted,  so  as  to  ascertain  whether  the 
death  was  due  to  natural  causes,  or  whether  it  was  the  re- 
sult of  violence.  If  the  latter,  then  the  nature  of  this  vio- 
lence, e.g.  whether  from  a  wound  (gunshot  or  otherwise), 
a  bludgeon,  an  axe,  hammer,  or  other  blunt  weapon;  or 
whether  occasioned  by  a  fall.  In  the  absence  of  all  external 
marks  of  violence, — then,  might  the  death  not  have  been  pro- 


THE   CORONER'S    INQUEST.  13 

duced  by  poison  ?  In  each  one  of  these  cases,  the  farther 
question  must  be  solved — was  the  death  homicidal,  suicidal, 
or  accidental  ? 

The  coroner's  jury  usually  consists  of  six  men  (the 
number  is  not  definitely  fixed  in  this  country),  who  are 
mostly  selected  from  the  neighborhood  where  the  inquest 
is  held.  Their  duty  consists  in  (i)  viewing  the  body  and 
establishing  its  identity,  and  (2)  in  holding  the  inquest, 
which  is  a  sort  of  petty  court,  wherein  inquiry  is  made  as 
to  the  cause  of  death,  and  (in  a  case  of  homicide)  to  ascertain, 
if  possible,  the  guilty  culprit.  For  this  purpose,  witnesses 
duly  subpoenaed  and  sworn  are  examined,  and  the  medical 
man  who  has  performed  the  post-mortem  examination 
(whether  he  be  the  coroner's  recognized  physician,  or  some 
other  who  has  been  specially  appointed  for  this  purpose) 
now  makes  his  detailed  report,  and  gives  his  opinion  as  to 
the  real  cause  of  death.  The  jury  having  heard  the  evi- 
dence, and  consulted  together,  bring  in  their  verdict,  which 
is  usually  in  accordance  with  the  report  of  the  medical 
officer.  In  some  cases,  particularly  in  cities,  where  the 
coroner  has  one  or  more  specially  appointed  physicians,  it 
is  not  considered  necessary  that  the  jury  should  personally 
view  the  body  before  holding  the  inquest ;  it  being  regarded 
as  sufficient  that  the  body  has  been  properly  identified  by 
the  examining  physician,  and  the  autopsy  carefully  made, 
and  the  result  duly  reported. 

It  will  be  observed  that  the  special  duty  of  the  coroner's 
inquest  is  to  discover  the  real  cause  of  death;  usually  it 
does  not  fall  within  his  province  to  discover  the  person  who 
caused  it.  Nevertheless,  it  does  sometimes  happen  that  in 
the  course  of  the  investigation,  suspicion  may  so  strongly 
point  to  some  particular  individual,  as  to  warrant  the 
coroner  to  commit  him  to  prison,  to  await  further  investiga- 


14  MEDICAL   JURISPRUDENCE. 

tion.  The  usual  verdict  in  cases  of  violent  death  (shown 
to  have  been  neither  suicidal  nor  accidental)  is,  that  of 
murder,  or  manslaughter,  against  some  person,  known  or 
unknown. 

As  the  post-mortem  examination  is  an  inseparable  part 
of  the  coroner's  inquiry,  and,  in  fact,  constitutes  its  most 
important  factor,  it  is  indispensable  that  it  should  be  per- 
formed in  the  most  careful  and  thorough  manner;  and  no 
one  is  fit  to  undertake  it  but  a  skilled  anatomist  and 
pathologist.  The  medical  man  should  never  permit  himself 
to  be  hurried  in  this  work ;  he  should  allow  himself  ample 
time,  and  always  perform  the  autopsy  by  daylight,  if  pos- 
sible, inasmuch  as  he  might  fail  to  distinguish  certain  alter- 
ations of  color  by  artificial  light.  When  it  is  remembered 
that  the  most  serious  issues  may  be  at  stake — even  those  of 
life  and  death — it  will  be  acknowledged  that  the  utmost 
caution  should  be  exercised  in  conducting  the  autopsy. 
There  may  be  cases,  involving  strong  suspicion  of  murder, 
where  it  might  be  deemed  advisable  that  the  post-mortem 
examination  should  be  performed  by  two  independent  ex- 
perts, in  order  to  avoid  the  imputation  of  ex  parte  influence. 
One  of  these  medical  examiners  should  represent  the  State, 
and  the  other  the  accused. 

In  giving  his  evidence  before  the  coroner's  jury  the  medi- 
cal man  should  not  undervalue  the  situation.  Although 
the  inquest  be  held  in  some  remote  hovel  or  barn,  and  the 
jury  be  composed  of  rude,  illiterate  persons,  he  should  not 
fail  to  remember  that  his  testimony  is  all  taken  down  by 
the  proper  officer,  and  that  it  will  surely  confront  him  at 
the  approaching  trial.  This  fact  should  alone  be  sufficient 
to  impress  upon  him  the  seriousness  of  the  occasion,  and 
remind  him  of  the  importance  of  drawing  up  his  report  with 
due  care  and  accuracy. 


MEDICAL    EVIDENXE.  15 

The  Criminal  Court. — After  the  coroner's  inquest  the 
case  (if  a  criminal  one)  is  sent  to  the  Grand  Jury,  who 
institute  a  preliminary  examination,  and  either  ignore  it  al- 
together, or  else  find  a  true  bill.  In  the  latter  event,  the  case 
next  comes  before  the  judge  and  petty  jury,  for  trial.  To 
this  trial  the  medical  witness  is  summoned  by  a  subpoena, 
which  he  cannot  evade,  but  which  it  is  his  duty  to  obey. 
Before  this  court  and  jury,  he  will  undergo  a  most  strict  and 
impartial  examination  as  to  his  opinion  of  the  cause  of  death, 
and  the  reasons  on  which  this  opinion  is  founded.  He  will 
be  questioned  most  closely,  in  the  cross-examination,  as  to 
his  professional  knowledge  and  acquirements,  the  extent  of 
his  opportunities  for  making  such  investigations  as  the  one 
now  pending,  the  accuracy  of  his  post-mortem,  or  toxico- 
logical  examination,  the  modes  of  distinguishing  between 
wounds  made  before  and  after  death,  the  method  of  dis- 
criminating between  the  effects  of  poisons  and  of  disease,  the 
danger  of  confounding  these  latter  together,  the  liability  to 
mistake  in  chemical  results,  and  a  hundred  other  matters, 
which  will  annoy  and  confuse  the  medical  witness  to  no 
small  degree,  unless  he  be  prepared  beforehand,  by  his 
thorough  medico-legal  knowledge  and  training.  A  medical 
witness  so  properly  fortified,  need  have  no  fear  for  himself;  for, 
as  he  goes  upon  the  stand  honestly,  to  testify  to  the  truth, 
"  he  need  only,"  in  the  language  of  the  late  Professor  Tay- 
lor, "bear  in  mind  two  considerations:  first,  that  he  should 
be  thoroughly  prepared  on  all  points  of  the  subject  on 
which  he  is  to  give  evidence;  and  secondly,  that  his  de- 
meanor should  be  that  of  an  educated  gentleman,  and  suited 
to  the  serious  occasion  on  which  he  appears." 

In  the  matter  of  Medical  Evidence  there  are  several  points 
that  require  a  brief  notice  here.  After  opening  the  case 
before  the   court,  the   prosecuting  attorney,  or   some   one 


]•;  MEDICAL   JURISPRUDE 

associated  with  him  in  the  prosecution,  calls  the  witnesses 
and  examines  them  "according  to  the  rules  of  evidence;" 
this  is  technically  called  the  examination  in  chief.  The 
"  rules  of  evidence  "  prohibit  counsel,  in  the  examination  in 
chief,  from  putting  leading  questions  to  the  witness,  i.  c., 
questions  that  suggest  their  own  answers;  and  for  the  reason 
that  the  witness  may  be  supposed  to  be  willing  to  say  any- 
thing favorable  suggested  to  him  by  his  own  counsel,  and 
to  repress  anything  unfavorable.  The  replies  of  the  witness, 
however,  should  always  be  given  with  equal  clearness  and 
precision,  to  both  the  counsel  for  the  defence,  and  for  tlve 
prosecution. 

The  cross-examination  next  follows  :  this  is  conducted  by 
the  counsel  for  the  prisoner,  and  is  especially  aimed  at  contra- 
dicting and  overthrowing,  if  possible,  the  witness's  previous 
testimony.  To  this  end,  the  counsel  plies  the  witness  with 
questions  which  are  strongly  "  leading,"  and  such  as  may 
most  strongly  suggest  any  facts  or  circumstances  which 
he  had  previously  withheld,  and  which  may  appear  favorable 
to  his  client.  A  counsel  for  the  defence  is  allowed  very 
considerable  latitude  in  the  cross-examination  of  the  witness, 
and  the  latter  should  always  be  well  prepared  to  meet  the 
attack,  with  conscious  strength,  and  calm  and  dignified  com- 
posure. If,  however,  the  advocate  transcends,  as  he  is  some- 
times tempted  to  do,  the  bounds  of  propriety  and  decorum, 
the  witness  has  always  the  right  to  appeal  to  the  court  for 
protection.  It  is  far  preferable  to  adopt  the  latter  course, 
than  to  attempt  to  argue,  or  recriminate  with  counsel,  since 
the  latter  has  the  witness  always  at  disadvantage  on  the  stand. 

The  rc-cxamination  sometimes  follows  the  cross-exam- 
ination of  the  witness,  when  it  becomes  necessary  to  clear 
up,  or  explain  any  matter  that  may  have  been  obscured  by 
the  cross-examination. 


EXPERTS.  17 

After  the  examination  of  the  State's  witnesses,  that  of  the 
witnesses  for  the  defence  follows.  And  here  the  same 
general  line  of  examination  is  pursued  as  in  the  former 
case.  When  the  medical  witness  for  the  defence  is  put  upon 
the  stand,  a  most  unpleasant  exhibition  is,  not  unfrequently, 
made,  of  one  expert  directly  contradicting  another  expert 
on  the  opposite  side,  and  both  of  them  medical  men  of 
equal  standing  and  worth  in  the  profession,  and  in  the  com- 
munity. Such  professional  tilting  is  sometimes  sneeringly 
designated  as  the  "war  of  the  experts,"  and  is  certainly 
deeply  to  be  regretted,  as  it  tends  greatly  to  prejudice 
both  the  court  and  the  public  against  expert  testimony  in 
general;  and  this,  of  course,  to  the  detriment  of  justice. 

It  is  proper  to  clearly  understand  the  difference  between 
an  ordinary  witness,  and  an  expert  witness.  The  former 
testifies  only  to  facts  which  he  has  seen,  or  heard,  or  learned 
from  personal  observation.  The  "  expert"  or  skilled  witness 
(expert us)  does  not  necessarily  testify  to  facts,  but  gives  his 
opinion  on  facts  observed  by  himself,  or  testified  to  by 
others.  An  expert  witness  is  supposed  to  be  specially  skilled 
in  the  matter  on  which  he  is  to  testify.  It  is  just  here,  we 
believe,  that  the  real  cause  of  difficulty  lies  in  medico-legal 
cases  involving  expert  evidence.  The  so-called  "experts" 
are  usually  taken  from  the  ranks  of  the  medical  profession. 
Such  persons,  because  they  are  doctors,  sometimes,  unfortu- 
nately, imagine  that  they  are  therefore  qualified  to  act  as 
experts,  without  any  previous  medico-legal  knowledge,  or 
training.  Of  course,  there  must  necessarily  be  a  conflict  of 
opinion  where  such  an  improvised  witness  is  opposed  to  the 
genuine  expert,  on  the  witness  stand.  We  believe  that  if 
all  the  experts  were  equally  skilled,  and  equally  qualified, 
and  equally  honest,  there  rarely  could  occur  any  conflict 
of  opinions    between   the    opposite    sides,  since   both   are 


18  MEDICAL   JURISPRUDENCE 

equally  desirous  of  discovering  and  testifying  to  the  truth, 
and  truth  is  always  undivided. 

No  one  should  presume  to  assume  the  position  of  an 
expert  witness  who  has  not  devoted  his  special  attention 
to  the  matter  under  consideration,  and  who  is,  therefore, 
able  really  to  enlighten  the  court  and  jury. 

The  expert  witness  has  his  rights  as  well  as  his  duties  and 
responsibilities.  One  of  these  rights  is  his  compensation. 
It  has  often  been  made  a  subject  of  just  complaint  that  an 
expert  witness  is  placed  upon  the  stand,  and  his  professional 
opinions,  which  may  be  of  the  utmost  value  in  the  pending 
case,  extorted  from  him  piecemeal,  by  the  questionings  of 
counsel,  and  yet  he  receives  as  his  compensation  merely  the 
pittance  of  one  dollar  and  a  half  a  day — the  pay  of  an  ordinary 
witness!  Some  high  legal  authorities  contend,  very  justly, 
that  the  expert  is  not  bound  to  submit  to  this  imposition, 
and  that  he  is  entitled  to  an  adequate  fee  for  his  services,  for 
which,  however,  he  should  arrange  with  the  party  calling  him, 
before  he  gives  his  evidence.  The  English  courts,  we 
believe,  have  not  yet  definitely  settled  this  matter.  We  are 
glad  to  see  that  a  recent  authority  *  uses  the  following 
pointed  language  concerning  this  matter :  "  No  witness  can 
be  compelled  to  give  his  opinion  in  the  witness  box. 
Further,  no  one  is  bound  to  accept  a  subpoena  merely  to 
state  opinions.  The  witness  that  can  speak  to  any  actual 
fact  connected  with  the  case  must  attend  the  trial,  if  required 
to  do  so,  but  the  expert,  however  wide  his  experience,  cannot 
be  forced  to  give  the  court  the  value  of  his  general  or  special 
knowledge."  There  can  be  no  question  as  to  the  propriety 
and  justice  of  this  position  ;  but  in  this  country,  the  practice 
of  the  courts  in  relation  to  the  compensation  of  medical 
experts,  is  by  no  means  settled.     In  the  great  majority  of 

-Tidy's  Legal  Medicine.     Part  I.  Lond.  1SS2  ;   p.  17. 


REMUNERATION    TO    EXPERTS.  19 

our  States,  the  laiv  allows  no  additional  compensation  to  the 
expert;  and  it  is  not  an  unfrequent  practice  to  subpcena  him  as 
an  ordinary  witness,  and  when  in  the  witness  box,  to  use  him 
as  an  expert.  What  shall  the  expert  do  in  such  a  case  ?  How 
shall  he  conduct  himself  consistently  with  his  own  dignity 
and  proper  rights?  Certainly,  the  court  would  not  use  a 
man's  private  property — the  work  of  his  hands,  his  skilled 
manual  labor,  or  the  product  of  his  farm  or  merchandise, 
without  adequate  compensation ;  why,  then,  should  they 
exact  from  him  that  which  is  the  result  of  the  labor  of  his 
brain,  than  which  nothing  can  be  more  exclusively  and 
definitely  a  man's  own  private  property  ?  It  is  to  be  regretted 
that  so  few  of  our  American  courts  and  legislatures  have 
appeared  to  recognize  the  true  bearings  of  this  subject,  so  that 
with  us  the  old  practice  still  prevails,  of  affording  no  legal 
protection  to  the  medical  expert,  in  the  matter  of  fees.* 

In  point  of  fact,  however,  it  rarely  happens,  in  important 
criminal  cases,  especially  in  poison  cases,  that  either  the 
prosecution  or  the  defence  would  venture  to  trust  their 
interests  to  a  reluctant  witness;  and  certainly  he  would  be 
a  reluctant  witness  who  had  been  dragged,  perhaps  hundreds 
of  miles  from  his  home  and  business,  by  a  subpcena,  which 
the  law  forces  him  to  obey,  and  who,  after  spending,  it  may 
be,  days  in  attendance  upon  the  court,  is  compelled  to  give, 
for  the  paltry  pittance  of  the  wages  of  a  day-laborer,  that 
which  has  caused  him  years  of  labor  and  study  to  acquire, 
in  the  shape  of  an  opinion,  on  which  may  turn  the  question 
of  life  or  death  to  the  prisoner  !  In  all  such  cases,  the 
ordinary  practice  is  to  arrange  beforehand  with  the  expert 
for  his  proper  fee;  and  the  witness  should  be  admonished 
to  look  carefully  about  his  interests   in  this  matter.     Let 

*  As  far  as  can  be  ascertained,  only  two  of  our  States  have  legislated  on 

this  subject. 


20  MEDICAL   JURISPRUDENCE. 

him  remember  that  the  district  attorney,  who  usually  directs 
the  affair,  has  no  authority  to  pay  his  fee ;  neither  does  this 
authority  lie  with  the  court.  The  only  responsible  parties 
in  the  case  are  the  county  commissioners,  or  some  other 
equivalent  county  authorities.  With  these  alone  ought  the 
expert  to  make  his  arrangements,  and  always  previously  to 
undertaking  the  case;  and  to  these  alone  can  he  look, 
legally,  for  his  fee. 

As  regards  the  obligation  of  a  witness  to  obey  a  subpoena 
when  he  is  to  be  questioned  only  as  to  his  opinion,  we  think 
that,  in  this  country,  the  mandate  of  the  court  is  obligatory  ; 
the  witness's  duty  is  to  obey  it,  and  then,  if  not  previously, 
endeavor  to  arrange  about  his  (compensation,  before  giving 
his  evidence. 

We  venture  a  word  of  caution  to  the  medical  witness. 
Before  undertaking  any  case,  or  consenting  to  act  as  an 
"  expert  "  therein,  be  sure  to  institute  a  thorough  examina- 
tion of  all  the  bearings  of  the  case, — its  pros  and  cons.  If 
retained  by  the  defence,  the  expert  has  the  right  to  examine 
the  report  of  the  State's  expert;  and  this  is  of  special  im- 
portance in  a  poison  case.  A  critical  examination  of  this 
report  will  enable  him  to  determine  whether  he  can  consci- 
entiously, and  on  scientific  grounds,  undertake  to  contradict 
and  oppose  the  conclusions  arrived  at  in  this  report.  It  is 
a  most  serious  and  responsible  position  for  him  to  assume, 
and  he  ought  to  assume  it  only  after  a  deliberate  study  of 
the  case,  and  a  strict  consciousness  of  his  ability  to  grasp 
it.  If  he  finds  nothing  in  the  report  that  he  cannot  thor- 
oughly endorse,  whether  the  results  of  chemical  or  other 
experiments,  or  whether  the  deductions  from  these  experi- 
ments in  the  shape  of  opinions,  our  advice  would  be  for  him 
frankly  to  decline  the  case  altogether.  He  should  never  go 
upon   the  witness  stand  as  a  mere  partisan,  nor  offer  his 


EXPERT    TESTIMONY.  21 

professional  shrewdness  and  tact,  for  pay,  to  the  highest 
bidder !  If,  however,  a  careful  scrutiny  of  the  report  has 
satisfied  him  that  the  State  has  not  made  out  its  case  (so 
far  as  the  scientific  evidence  goes),  but  that  serious  blunders 
have  been  committed  in  the  chemical  and  other  experiments 
performed,  whereby  most  erroneous  conclusions  have  been 
reached,  and  which  may  vitally  affect  the  result,  then  we 
are  of  the  opinion  that  the  expert  not  only  need  not 
hesitate  to  take  the  case,  but  that  it  is  his  bounden  duty 
to  do  so,  in  order  that  he  may  aid  in  carrying  out  the  ends 
of  justice. 

This  whole  matter  of  expert  testimony  has  long  engaged 
the  attention  of  some  of  the  ablest  minds  in  both  the  pro- 
fessions of  law  and  medicine,  but  with  no  very  definite 
results.  No  doubt,  our  present  system  of  volunteer  medical 
experts  is  open  to  serious  objections,  which,  under  our 
present  laws,  cannot  be  remedied.  The  only  true  and 
proper  system,  as  it  seems  to  us,  is  for  each  State  to  ap- 
point one  or  more  experts,  who  shall  be  State  officers, 
physicians  of  thorough  education  and  experience,  and  train- 
ing in  this  particular  line,  who  shall  devote  their  time  and 
attention  exclusively  to  this  duty,  and  for  which  they  shall 
receive  an  adequate  compensation.  Such  an  office,  properly 
filled,  and  kept  aloof  from  all  political  considerations,  would, 
we  believe,  be  of  real  benefit  to  the  State.  It  would,  to  a 
great  extent,  if  not  completely,  abolish  the  unseemly  con- 
tention of  the  experts  in  the  court-room,  inasmuch  as  the 
State  expert  (whose  professional  ability  and  moral  standing 
should  be  absolutely  unquestioned)  would  be  present  at 
every  important  trial,  and  give  to  the  court  and  jury  the 
results  of  his  previous  investigations  in  the  case;  and,  more- 
over, since  he  is  to  be  presumed  to  be  entirely  impartial, 
without   bias    to    either    the    prosecution    or    defence,    his 


22  MEDICAL   JURISPRUDENCE. 

opinion  would  be  generally  received  as  final  by  both  sides, 
and  thus  both  contention  and  expense  would  be  avoided. 

The  above  system  of  medical  expert  testimony  re- 
sembles, in  many  respects,  that  of  Germany,  which  we  regard 
as  superior  to  that  of  other  countries. 

There  are  a  few  practical  rules  relating  to  the  giving  ot 
evidence,  which  it  is  well  the  medical  expert  should  observe. 
The  first  of  these  is,  that  he  should  prepare  himself  thor- 
oughly upon  all  the  points  bearing  on  the  case,  in  which  he 
is  called  to  give  evidence.  This  he  should  do  in  order  to 
further  the  ends  of  justice,  and  also  to  avoid  personal 
censure.  He  should  be  accurate  as  to  weights,  measures, 
distances,  size,  relationship  of  objects,  etc. 

Secondly.  He  should  maintain  a  quiet,  dignified  and  com- 
posed demeanor  on  the  stand,  not  exhibiting  any  irritability 
of  temper,  however  much  he  may  feel  provoked  by  the  rude- 
ness of  the  opposing  counsel.  He  should  beware  of  any 
display  of  arrogance,  or  assumption  of  manner,  or  of  stub- 
bornness, or  testiness  of  behavior,  which  are  sure  to  make 
him  appear  to  disadvantage  in  the  court  room. 

Thirdly.  The  witness  should  give  his  answers  in  a  clear 
and  audible  tone,  addressing  himself  rather  to  the  jury  than 
to  counsel,  since  the  former  are  specially  interested  in  his 
replies  ;  and  these  replies,  together  with  his  explanations, 
should  always  be  given  in  the  simplest  possible  language ; 
and  they  should  be  free  from  all  ambiguity,  otherwise  they 
will  require  explanation,  which  is  apt  rather  to  weaken  the 
testimony. 

Fourthly.  He  should  never  be  afraid  to  say  "I  don't 
know,"  if  he  does  not  know.  Nothing  is  more  dangerous 
than  for  a  witness  to  attempt  to  guess,  for  fear  of  being 
thought  ignorant. 

Fifthly.     He    should    particularly    avoid    the    use   of  all 


DYING    DECLARATIONS.  23 

technical  expressions  and  learned  formulae,  in  giving  his 
description  of  the  results  of  an  autopsy,  or  of  a  toxicological 
examination,  etc.  For  example,  instead  of  saying  that  "the 
integuments  of  the  cranium  were  reflected  back,  so  as  to 
expose  the  calvarium,"  he  should  simply  announce  that  "  the 
scalp  was  thrown  back,  and  the  skull,  exposed;"  and  instead 
of  telling  the  jury,  in  grandiloquent  phraseology,  that,  in  a 
case  of  assault  and  battery,  he  had  found  that  the  prosecutor 
"  had  received  a  severe  contusion  over  the  lower  portion  of 
the  frontal  bone,  producing  extensive  ecchymosis  around  the 
eye,  together  with  considerable  infiltration  of  the  subjacent 
areolar  tissue,"  he  should  clear  up  the  matter  at  once,  by 
telling  them,  in  plain  English,  that  the  man  had  gotten  "a 
black  eye"  (Taylor).  All  such  pomposity  and  pedantry  will, 
of  course,  be  avoided  by  every  sensible  and  well-bred  witness, 
since  it  is  certain  to  expose  him  to  well-merited  ridicule  and 
contempt. 

Dying  Declarations. — By  this  term  is  understood  such 
declarations  as  are  made  by  a  dying  person,  who,  at  the  time, 
believed  he  was  in  actual  danger  of  death,  and  that  his 
recovery  was  impossible.  Such  declarations  are  received  in 
evidence  without  being  sworn  to.  The  law  presumes  that 
all  such  declarations,  made  at  so  solemn  a  crisis  as  at  a 
dying  moment,  must  be  sincere.  They  may  not,  however, 
necessarily  be  true,  although  sincere,  i.  c,  believed  in,  at  the 
time,  by  the  deceased.  Dr.  Taylor  quotes  an  instance  of  a 
dying  woman  in  St.  Thomas'  Hospital,  who  accused  a  man 
of  assaulting  her.  He  was  found  guilty  and  executed.  A 
year  after  the  execution,  the  real  murderers  were  discovered, 
and  his  innocence  established.  These  declarations,  more- 
over, must  relate  to  the  actual  circumstances  of  the  death, 
and  to  nothing  else. 


24  MEDICAL   JURISPRUDENCE. 

A  magistrate,  if  he  can  be  had,  is  the  proper  person  to 
take  down  the  dying  man's  declarations,  the  physician  in 
attendance  merely  giving  his  opinion  as  to  the  hopelessness 
of  the  case,  and  the  soundness  of  the  man's  mind.  In  the 
absence  of  the  magistrate,  the  medical  man  is  the  best 
person  to  receive  the  dying  declaration,  or  confession  ;  and 
he  should  content  himself  by  simply  writing  down  the  exact 
words  of  the  dying  person,  without  any  interpretation  of 
them  by  himself.  He  should  then,  if  possible,  make  him 
sign  the  declaration,  after  first  reading  it  over  to  him. 


MOLECULAR    AND    SOMATIC    DEATH.  25 


CHAPTER  II. 

PHENOMENA  AND  SIGNS  OF  DEATH. 
SECTION  I. 

MOLECULAR  AND  SOMATIC  DEATH. — THE  IMMEDIATE  CAUSE  <>F 
DEATH,  IN  ALL  CASES,  TO  BE  FOUND  IN  EITHER  THE  HEART. 
LUNGS,  OR  BRAIN. — CHARACTERISTIC  POST-MORTEM  EVIDENCES  OF 
THESE  VARIETIES  OF  DEATH. — THE  "SIGNS  OF  DEATH." — CESSA- 
TION OF  THE  CIRCULATION  AND  RESPIRATION. — CHANGES  IN  THE 
EYES. — PALLOR   OF   THE   BODY. 

By  molecular  death  is  to  be  understood  the  incessant  dis- 
integration of  tissue  which  is  going  on  in  the  body  during 
the  active  processes  of  life ;  the  waste  of  material  thus 
produced  being  compensated  by  the  never-ending  work  of 
reparation.  In  youth,  the  supply  is  in  excess  of  the  waste, 
and  growth  is  the  result.  In  advanced  age,  the  reverse  is 
the  case.  Somatic  death  is  the  cessation  of  all  the  vital 
functions  of  the  body,  or  the  death  of  the  whole  body.  The 
latter  is  the  popular  idea  of  death ;  and  the  time  when  it 
takes  place  is  generally  recognizable.  The  precise  period 
when  universal  molecular  death  occurs  cannot  be  accurately 
determined.  No  doubt,  molecular  life  may  continue  some 
time  after  somatic  death,  as  is  evidenced  by  post-mortem 
caloricity  (via7,  post.)  and  by  certain  acts  of  nutrition  and 
secretion,  such  as  the  growth  of  the  hair  and  nails. 

Although  the  outlets  of  human  life  are  so  numerous  and 
varied,  and  the  phenomena  attending  the  dissolution  of  the 
body  are  equally  diversified,  the  immediate  or  actual  cause 
of  death,  in  every  instance,  must  be  referred  to  an  arrest  of 
the  function  of  one,  or  other  of  the  three  great  centres  of  life 
— the  heart,  the  lungs,  and  the  brain.     And  so  intimately 


26  MEDICAL   JURISPRUDENCE. 

are  the  functions  of  these  three  "centres  "  connected  together, 
that  when  one  ceases  to  act,  the  actions  of  the  other  two  are 
speedily  brought  to  a  standstill.  Each  one  of  these  three 
varieties  has  its  own  special  phenomena  or  signs ;  and  each 
exhibits  its  own  peculiar  or  characteristic  post-mortem 
appearances.  We  adopt  Bichat's  classification  of  (i)  death 
beginning  at  the  brain,  (2)  death  beginning  at  the  heart, 
and  (3)  death  beginning  at  the  lungs. 

I.  Death  Beginning  at  the  Brain — Coma. — Symptoms. — 
Stupor,  more  or  less  profound;  insensibility  to  external  im- 
pressions; loss  of  consciousness ;  breathing  slow,  stertorous, 
and  irregular;  respiration  gradually  ceases,  as  the  medulla 
oblongata  begins  to  be  affected.  The  chest  ceases  to  ex- 
pand; the  blood  is  no  longer  aerated;  the  pulmonary  circu- 
lation is  arrested;  the  lungs  cease  to  act,  and  finally  the 
heart's  pulsations  are  brought  to  a  stop. 

Post-mortem  appearances. —  1.  Effusion  of  blood,  or  serum 
in  the  brain  or  cavities,  caused  by  (a)  apoplexy,  (b)  rupture 
of  vessels,  from  injury  or  fracture  of  the  skull.  2.  Embolism. 
3.  Concussion  from  a  blow  or  fall.  4.  Abscess,  tumor,  or 
other  organic  disturbance.  5.  Congestion  of  the  vessels  of 
the  brain,  caused  by  (a)  disease,  (6)  narcotic  poisons,  (c)  cer- 
tain mineral  poisons,  as  barium  and  arsenic. 

II.  Death  Beginning  at  the  Heart — Syncope. — The  heart 
may  cease  to  act,  from  two  distinct  causes :  (1)  from  a 
deficiency  in  the  quantity  of  blood,  its  normal  stimulant 
(anosmia),  and  (2)  from  a  defect  in  the  quality  of  the  blood, 
or  from  a  loss  of  heart-power  (asthenia). 

Ancemia  is  produced  by  sudden  loss  of  blood,  (1)  disease, 
as  in  rupture  of  an  aneurism ;  (2)  uterine  and  other  hemor- 
rhage;   (3)  sudden    discharges,  etc.;    (4)  violence,  as  from 


DEATH  FROM  THE  LUNGS.  27 

wounds  of  heart  and   large  vessels,  causing  fatal   hemor- 
rhage. 

Symptoms. — A  mortal  paleness  of  face  ;  lividity  of  lips ; 
vertigo;  cold  sweat ;  dimness  of  vision;  ringing  in  the  ears; 
slow,  weak  and  fluttering  pulse ;  gradual  insensibility.  There 
may  also  be  nausea  and  vomiting,  hallucinations,  delirium, 
jactitations,  irregular  breathing,  sighing,  and  convulsions 
before  death.  The  nervous  symptoms  are  due  to  want  of 
brain  power,  in  consequence  of  a  deficient  supply  of  blood. 

Post-mortem  appearances. — Heart  contracted  and  empty 
(if  early  inspected).  If  life  has  been  protracted  for  several 
hours,  a  heart  clot  may  be  found. 

Asthenia. — Here,  the  cause  of  the  cessation  of  the  heart's 
action  is  either  a  defect  in  the  quality  of  the  blood,  or  some 
disorder  of  the  organ  producing  a  loss  of  heart  power:  (i) 
by  disease,  as  (a)  various  cardiac  disorders,  such  as  fatty 
degeneration,  etc ;  (b)  all  exhausting  diseases,  as  phthisis, 
cholera,  cancer,  etc. ;  (2)  starvation;  (3)  certain  injuries,  as 
blows  on  epigastrium  ;  (4)  certain  poisons,  as  digitalis, 
prussic  acid,  and  upas. 

Symptoms. — Coldness  of  hands  and  feet;  lividity  of  lips 
fingers,  toes,  nose  and  ears ;  extreme  muscular  weakness; 
feeble  pulse ;  senses  and  intellect  not  affected,  but  preserved 
to  the  last.  This  latter  is  well  seen  in  the  collapse  of  Asiatic 
cholera. 

Post-mortem  appearances. — The  heart  not  contracted ; 
its  cavities  contain  more  or  less  blood,  or  else  are  dilated  and 
flabby. 

III.  Death  from  the  Lungs  —  Apncea  —  {Asphyxia). — 
Respiration  may  be  arrested  (1)  by  any  mechanical  impedi- 
ment to  the  ingress  of  air  (oxygen)  into  the  lungs,  as  (a) 
pressure  on  the  thorax ;  (b)  tetanic  spasm  of  the  muscles  of 


28  MEDICAL   JURISPRUDENCE. 

respiration, as  in  tetanus  and  strychnia  poison;  (c)  paralysis 
of  the  pneumogastric,  or  phrenic  nerves ;  (d)  exhaustion  of 
muscular  power  from  debility,  or  cold ;  (e)  foreign  bodies  in 
the  air  passages  ;  (/)  compression  of  the  throat,  as  in  hanging 
and  strangling  ;  (g)  suffocation ;  (h)  drowning.  2.  By  dis- 
ease, as  pneumonia,  phthisis,  etc.,  spasm  of  the  glottis, 
cedema  of  the  glottis,  pharyngeal  abscess,  and  embolism 
of  the  pulmonary  artery.  (Strictly  speaking,  most  of  these 
diseases  cause  death,  through  mechanical  interference  with 
breathing.) 

Symptoms. — Great  dyspncea,  lividity  of  the  face,  loss  of 
consciousness,  vertigo,  and  convulsions. 

Post-mortem  appearances. — The  right  side  of  the  heart 
and  the  whole  venous  system  are  usually  filled  with  dark 
blood;  the  left  side,  together  with  the  arteries,  is  generally 
empty.  Cases  are  however  reported  where  the  right  cavities 
of  the  heart  were  found  empty.  The  lungs  themselves  are 
nearly  always  gorged  with  dark  blood ;  but  there  are  some 
exceptions  to  this,  which  will  be  noticed  hereafter. 

By  keeping  in  mind  the  foregoing  varieties  of  somatic 
death,  together  with  the  characteristic  post-mortem  appear- 
ances attendant  on  each,  the  examiner  will  be  considerably 
aided  in  arriving  at  a  definite  conclusion,  as  to  the  real  cause 
of  death,  in  any  particular  case. 

In  every  inquest  over  a  dead  body  four  important  ques- 
tions will  present  themselves  for  solution:  I.  The  reality 
of  the  death.  2.  The  cause  of  the  death.  3.  The  time  that 
has  elapsed  since  the  death.  4.  In  the  case  of  the  body  of 
a  new-born  infant, — was  it  born  alive? 

I.  The  first  of  these  questions  comprises  the  phenomena 
and  signs  of  death.  How  can  we  distinguish  a  case  of  real 
from    one    of  apparent  death?     In    the   great    majority  of 


SIGNS   OF    DEATH.  29 

instances,  of  course,  there  is  no  practical  difficulty;  but  ex- 
ceptional cases  do,  at  times,  present  themselves  in  persons 
recently  dead,  where  the  corpse  still  retains  so  much  the 
appearance  of  life,  as  to  occasion  some  doubts  about  the 
reality  of  dissolution.  The  natural  horror  of  being  buried 
alive  also  suggests  the  most  scrupulous  caution  in  the  mat- 
ter, although  we  rarely,  if  ever,  hear  of  cases  of  premature 
burial  in  civilized  countries;  yet  instances  are  not  wanting 
to  show  that  such  may  have  actually  occurred,  in  places 
where  a  fatal  pestilence  has  prevailed  to  such  a  degree  as 
to  produce  a  panic,  and  demoralize  the  community.  Dr. 
Tidy  {Legal  Med.  p.  30)  informs  us  that  Professor  Nussbaum, 
of  Munich,  states  "  that  he  believes  many  to  have  been  buried 
during  the  war  (Franco-German)  that  were  not  really  dead, 
but  merely  suffering  from  an  extreme  lethargy  arising  from 
loss  of  blood,  exhaustion,  hunger,  cold  and  fear"  (Jour,  de 
Med.  de  Bruxelles,  February,  1871). 

The  following  may  be  regarded  as  the  Signs  of  Death. 
We  are,  however,  of  the  opinion  that  no  single  sign  should 
be  relied  upon  exclusively,  but  that  several  "  signs  "  should 
always  be  present  in  determining  the  question. 

I.  The  complete  and  continuous  cessation  of  the  functions 
of  ciradation  and  respiration.  In  some  cases  of  apparent 
death  these  two  functions  seem  to  be  suspended  for  a  time, 
as  in  syncope,  trance,  catalepsy,  etc.;  but  the  suspension  is 
not  absolute,  but  only  apparent.  The  absence  of  the  pulse 
at  the  wrist  is  no  criterion  of  the  suspension  of  the  circula- 
tion, as  this  may  be  going  on  so  feebly,  as  only  to  be  detected 
by  a  very  close  stethoscopic  examination  of  the  heart,  which 
should  never  be  omitted  in  cases  of  doubt.  The  condition 
of  both  the  circulation  and  respiration,  in  such  cases  of 
apparent  death  simply  resembles  that  of  certain  animals  in 


30  MEDICAL    JURISPRUDENCE. 

the  state  of  hybernation.  Thus,  M.  Bouchut  informs  us 
that  in  the  marmot,  while  the  heart-beats  during  its  state  of 
activity  amount  to  80  or  90  a  minute,  they  are  reduced 
down  to  8  or  9  very  feeble  pulsations  during  the  period  of 
hybernation.  Instances  are  recorded  (like  that  of  Colonel 
Townshend,  by  Dr.  Cheyne)  of  a  voluntary  suspension  of 
the  heart's  action ;  but  as  these  cases  occurred  many  years 
ago,  before  the  discovery  of  auscultation,  it  is,  we  think, 
highly  probable  that  the  suspension  was  not  absolute,  but 
only  reduced  down  to  so  fine  a  point  as  to  have  escaped 
notice.  It  is  certainly  contrary  to  all  scientific  reasoning 
that  life  can  continue  many  minutes  without  the  circulation 
of  the  blood ;  therefore  we  need  have  no  hesitation  as  to 
the  reality  of  death,  if  we  can  be  positively  certain  of  the 
continuous  arrest  of  this  function,  say  for  one  hour.  The 
converse  of  this  proposition,  however,  is  not  always  true  ; 
that  is,  the  pulsation  of  the  heart  may  continue  for  a  brief 
space  of  time  after  actual  death.  Duval  mentions  having 
seen  the  heart  of  a  criminal  beat  fifteen  minutes  after  decapi- 
tation, the  left  auricle  pulsating  for  an  hour.  This  same 
phenomenon,  as  is  well  known,  is  witnessed  still  more 
remarkably  in  the  heart  of  the  turtle,  and  also  of  the  shark, 
which  will  continue  to  pulsate  many  hours  after  removal 
from  the  body. 

This  question  of  the  beating  of  the  heart  in  a  still-born 
infant  being  regarded  as  a  valid  sign  of  life,  will  be  dis- 
cussed hereafter,  under  the  title  of  Live  Birth. 

The  same  remarks  may  be  made  with  regard  to  the  func- 
tion of  respiration.  The  absolute  and  continuous  cessation 
of  breathing — say  for  one  hour — may  be  regarded  as  a  posi- 
tive sign  of  death.  In  cases  of  apparent  death,  as  already 
remarked,  this  function  may  apparently  be  suspended ;  but 
it  is  in  reality  only  reduced  down  to  its  minimum  of  action. 


CONDITION    OF    THE    EYES.  31 

This  likewise  should  be  verified  by  careful  and  repeated 
auscultation.  The  common  practice  of  holding  a  feather 
near  the  nose  or  mouth  may  serve,  by  its  movements,  to 
indicate  breathing.  So  likewise  the  deposit  of  moisture  on 
a  mirror,  held  in  the  same  position,  will  indicate  the  feeblest 
respiration.  But  neither  of  these  is  an  absolutely  positive 
sign,  since  they  both  fail  when  applied  in  the  case  of  the 
hybernating  animal,  which  we  know  is  really  alive. 

Another  method  is  to  place  a  small  vessel  containing 
mercury  on  the  thorax  of  the  body  lying  on  its  back ;  the 
slightest  respiratory  action  will  be  indicated  by  the  move- 
ments of  a  reflected  image,  made  to  fall  on  the  surface  of  the 
bright  metal. 

It  may  be  remarked  that  in  cases  of  trance,  catalepsy, 
and  other  instances  of  suspended  animation,  the  body  never 
exhibits  either  the  pallor,  or  coldness  of  real  death.  More- 
over, if  a  ligature  be  applied  around  the  finger  of  a  corpse, 
no  change  of  color  will  be  observed;  but  if  the  experiment 
be  made  on  a  living  body,  the  tip  of  the  finger  will  become 
of  a  deep  red  or  purple  color,  in  consequence  of  the  arrest 
of  the  capillary  circulation  at  that  spot. 

II.  The  Condition  of  the  Eyes. — The  changes  produced  in 
the  eyes  by  death  consist  (i)  in  the  entire  loss  of  sensibility 
to  light :  the  pupils  neither  contract  nor  expand  under  this 
stimulus.  This,  however,  cannot  be  regarded  as  a  positive 
sign,  since  the  same  insensibility  to  light  is  witnessed  in 
certain  cerebral  affections  during  life ;  it  is  also  the  result  of 
the  action  of  certain  poisons.  (2)  The  action  of  atropia 
and  other  mydriatics  to  expand  the  pupil,  and  of  calabar 
bean  to  contract  it  during  life,  is  lost  within  a  few  hours 
after  death.  These  agents  do,  however,  produce  a  visible 
effect  if  applied  very  soon  after  the  cessation  of  life,  and 


32  MEDICAL   JURISPRUDENCE. 

before  the  body  has  become  cold,  and  all  muscular  irrita- 
bility has  ceased.  (3)  The  cornea  loses  its  transparency, 
and  the  eyeball  its  elasticity,  very  speedily  after  dissolution. 
But  these  conditions  may  likewise  exist  before  death,  as 
the  effects  of  disease.  In  apparent  death,  the  cornea  retains 
its  translucency ;  the  papilla  of  the  retina  is  of  a  rose-red 
color ;  and  the  fundus  of  the  eye  is  furrowed  by  the  arteries 
and  veins  of  the  retina.  At  the  moment  of  death,  the 
papilla  of  the  optic  nerve  becomes  quite  pale,  and  the  cen- 
tral artery  of  the  retina  disappears  (M.  Bouchut,  La  Tribune 
Medicate,  No.  47,  1868).  It  should  also  be  remarked  that  the 
eye  sometimes  retains  its  lustre  after  death,  as  is  witnessed 
after  poisoning  by  prussic  acid  and  carbon  dioxide. 

III.  The  Ashy  Pallor  of  the  Body. — This  sign  is  very  uni- 
form, though  not  without  some  exceptions,  as  in  the  case 
of  persons  of  very  florid  complexions,  and  in  exceptional 
instances  where  the  cheeks  retain  their  pink  color  for  some 
days  after  death,  so  as  to  occasion  some  uncertainty  as  to 
the  actual  fact  of  death  in  the  minds  of  relatives.  It  is  also 
wanting  in  cases  of  death  from  yellow  fever  and  jaundice ; 
moreover,  the  red,  inflammatory  zones  around  ulcers,  tattoo 
marks,  the  spots  of  purpura,  and  ecchymoses  or  bruises,  do 
not  disappear  after  death.  It  must  also  not  be  forgotten 
that  a  death-like  pallor  is  seen  in  cases  of  swooning,  and 
sometimes  in  the  cold  stage  of  ague  and  in  collapse. 

SECTION  11. 
SIGNS     OF      DEATH      CONTINUED. — LOSS      OF     ANIMAL      HEAT. — POST- 
MORTEM    CALORICITV. — RIGOR   MORTIS. — POST-MORTEM      LIVIDITY, 
OR   SLGGILLATION. 

IV.  Loss  of  Animal  Heat. — During  life  the  animal  body 
possesses  the  wonderful  faculty  of  maintaining  its  own 
normal    temperature  (about  980   F.)  independently  of  the 


LOSS    OF    ANIMAL    HEAT.  3o 

surrounding  medium.  This  is  effected  as  the  result  of 
certain  vital  processes.  When  these  cease  at  the  moment  of 
dissolution,  the  temperature  of  the  body  immediately  begins 
to  decline,  and  it  continues  so  to  do  progressively  until  it 
attains  that  of  the  surrounding  medium.  It  never  gets 
lower  than  the  latter,  unless  the  temperature  of  this  medium 
becomes  suddenly  increased  ;  then,  for  a  while,  the  body  will 
be  really  colder  than  the  temperature  of  the  atmosphere. 
The  sense  of  touch  does  not  convey  an  accurate  idea  of 
the  actual  coldness  of  the  dead  body,  since  the  conducting 
power  of  the  tissues  varies  materially.  The  direct  appli- 
cation of  the  thermometer  to  the  body  is  the  only  safe 
criterion. 

The  time  when  the  cooling  of  the  body  is  completed  may 
be  stated  to  be,  on  the  average,  fifteen  to  twenty-four  hours. 
Prof.  Casper  makes  it  from  eight  to  twelve  hours.  But  it 
varies  very  considerably,  according  to  the  condition  of  the 
body  itself,  according  to  the  medium  in  which  it  is  kept 
after  death,  and  also  according  to  the  manner  of  death. 
Thus,  fat  bodies  retain  heat  longer  than  lean  ones ;  the 
bodies  of  young  children  and  of  old  persons  cool  more 
rapidly  than  those  of  adults;  whilst  the  bodies  of  those  who 
die  from  lightning,  or  suffocation  are  said  to  retain  heat 
longer  than  others. 

The  body  cools  more  rapidly  if  exposed  to  the  air, 
unclothed,  than  if  covered  up  in  the  bed  clothes;  also  in  a 
large,  airy  apartment,  than  in  a  small,  close  room.  It  will 
cool  more  rapidly  in  water  than  in  the  air.  In  death  from 
chronic  wasting  diseases,  and  also  in  cholera,  the  body  cools 
very  rapidly.  According  to  Dr.  Taylor,  loss  of  blood  does 
not  hasten  the  cooling  process. 

The  interior  of  the  body  retains  its  heat  considerably 
longer  than   the   surface,  so   that  if  an    autopsy  be   made 


:;i  MEDICAL   JURISPRUDENCE. 

twenty-four  hours  after  death,  or  when  its  exterior  feels  per- 
fectly cold,  the  abdominal  viscera  may  exhibit  a  temperature 
twenty  degrees,  or  more,  higher  than  that  of  the  surface. 

It  should  not  be  forgotten  that  coldness  of  the  body  is  a 
frequent  phenomenon  of  sickness  ;  it  is  witnessed  in  hysteria 
and  ague,  also  in  cholera.  Its  value  as  a  sign  of  death  con- 
sists in  the  fact  that  it  is  progressive,  and  continuous,  whilst 
the  coldness  of  disease  is  sudden,  and  not  permanent. 
Hence,  the  degree  of  coldness  of  the  body  will  often  be  a 
good  indication  of  the  time  that  has  elapsed  since  death. 

The  singular  phenomenon  is  sometimes  exhibited  of  a 
rise  of  temperature  after  death,  instead  of  a  fall.  This  excep- 
tional condition  occurs  in  the  bodies  of  persons  who  have 
died  from  yellow  fever,  cholera,  tetanus,  smallpox,  and  some 
other  acute  disorders.  The  precise  cause  of  this  singular  rise 
of  temperature  {post-mortem  caloricity)  is  not  clearly  under- 
stood. In  some  instances  the  increase  of  heat  amounted  to 
nine  degrees  F.  Dr.  Davy  records  a  post-mortem  tem- 
perature of  1 1 30  F.  in  the  pericardium.  We  must  suppose 
in  these  cases  that,  after  general  or  somatic  death,  there  still 
lingers  some  remnant  of  vitality  in  the  tissues,  or  rather 
that  molecular  life  has  continued  after  the  cessation  of 
somatic  life.  We  know  that  muscular  irritability  and  con- 
tractility continue  for  many  hours  (under  certain  conditions) 
after  death,  and  this  undoubtedly  indicates  the  continuance 
of  their  molecular  activity,  up  to  a  certain  point. 

Another  fact  to  be  here  noticed  is  that  the  rate  of  cooling 
after  death,  although  progressive,  is  not  uniform ;  it  is 
much  more  rapid  during  the  earlier  hours,  than  later.  Dr. 
Goodhart's  observations  show  that  during  the  first  three 
hours  after  death  the  loss  of  heat,  per  hour,  amounted,  in 
the  robust,  to  3.5  °,  in  the  emaciated,  to  4.70  ;  whilst,  when 
the    body  was    nearly  cold,  the  loss,  per  hour,  was,  in  the 


CADAVERIC    RIGIDITY.  35 

emaciated,  1.120  and  in  the  robust,  1.260  (Tidy's  Leg.  Med., 
P-  49). 

V.  Cadaveric  Rigidity,  or  Rigor  Mortis. — By  this  is  under- 
stood the  stiffening  of  the  body,  so  generally  observed  after 
death.  It  usually  occurs  simultaneously  with  the  cooling 
process.  It  may  be  stated  to  be  universal  in  death  from 
any  cause,  and  to  be  present  in  the  lower  animals,  as  well  as 
in  man.  In  some  instances,  however,  it  is  so  transient  as 
to  escape  notice.  It  comes  on  at  very  variable  periods, 
from  a  few  moments,  to  eighteen  to  twenty  hours  after 
death.  This  remarkable  variation  in  its  approach  is  chiefly 
due  to  the  condition  of  the  muscular  system  at  the  time  of 
death.  Its  duration  is  equally  variable,  lasting  from  a  few 
moments,  to  many  hours,  or  even  weeks.  After  the  rigidity 
passes  off,  the  body  regains  its  original  pliancy,  and  decom- 
position immediately  commences.  As  a  general  rule,  the 
putrefaction  of  the  body  is  retarded  until  the  rigor  mortis 
has  passed  off. 

■  It  commences  usually  in  the  muscles  of  the  eye,  which 
often  become  rigid  within  a  few  minutes  after  death ;  next 
in  the  muscles  of  the  neck  and  lower  jaw;  then  in  the  chest 
and  upper  extremities  ;  afterwards  in  the  muscles  of  the 
abdomen  and  lower  limbs.  The  rigidity  generally  passes 
off  in  the  same  order;  thus  the  legs  frequently  remain  quite 
rigid,  after  the  upper  portion  of  the  body  has  regained  its 
suppleness. 

The  seat  of  the  rigor  mortis  is  undoubtedly  the  muscular 
system.  That  it  is  in  no  wise  dependent  upon  the  nervous 
system,  is  proven  by  the  fact  that  all  the  nerves  supplying  a 
muscle  may  be  divided,  and  yet  the  muscle  will  continue  to 
act,  contracting  under  the  galvanic  stimulus.  But  it  ceases 
immediately  on  division  of  the  muscle.     Even  the  removal  of 


36  MEDICAL   JURISPRUDENCE. 

the  brain  and  spiral  marrow  has  no  effect  in  preventing  the 
muscular  contraction.  Again,  the  muscles  of  a  paralyzed 
limb  become  equally  rigid  with  those  in  sound  health.  The 
cause  of  the  contraction  is  usually  ascribed  to  the  coagulation 
of  the  muscular  plasma  (myosin),  an  albuminous  principle 
possessing  the  property  of  coagulation  to  a  high  degree. 
The  chemical  action  of  a  muscle  in  rigor  mortis  is  acid 
(reddens  blue  litmus),  but  it  becomes  alkaline  after  the 
rigidity  passes  off.  While  in  the  state  of  rigor  mortis,  the 
muscle  is  opaque;  before  this,  it  is  partially  translucent. 
Brown-Sequard  has  shown  that  a  current  of  arterial  blood 
will  restore  muscular  contractility  to  a  rigid  limb. 

The  duration  of  rigor  mortis  is  one  of  its  most  important 
features.  As  already  observed,  this  is  extremely  variable, 
although,  as  a  rule,  it  does  not  set  in  until  the  body  has 
begun  to  cool ;  still,  in  some  of  the  lower  animals,  and 
notably  in  birds,  it  often  manifests  itself  while  the  body  is 
still  warm.  From  the  observations  of  Brown-Sequard  and 
others,  it  appears  that  the  period  after  death  when  the  rigor 
mortis  manifests  itself,  together  with  its  duration,  is  de- 
pendent chiefly,  if  not  altogether,  upon  the  previous  degree 
of  muscular  exhaustion.  To  properly  understand  this,  it 
should  be  remembered  that  immediately  after  death  the 
muscles  are  in  a  state  of  complete  relaxation,  giving  to  the 
body  perfect  pliancy.  This  condition  may  last  for  so  brief 
a  space  of  time  as  not  to  be  noticed,  though  usually  it 
continues  for  three  or  four  hours,  when  rigidity  commences. 
During  this  period  of  relaxation,  the  muscles  have  not  yet 
lost  their  molecular  life,  so  that  they  will  respond  to  galvanic 
and  other  stimuli.  Hence,  although  the  contraction  of  a 
muscle  by  electricity  is  no  positive  sign  of  somatic  life,  still 
it  will  enable  us  to  conclude  either  that  the  person  is  yet 
alive,    or    more    probably,    that    death    has    very    recently 


CADAVERIC    RIGIDITY.  37 

occurred.  The  cessation  of  all  muscular  contractility  under 
galvanic  stimulus  is  a  proof,  not  only  of  the  death  of  the  indi- 
vidual, but  it  also  indicates  that  the  death  was  not  very  recent 
— hardly  within  three,  or  four  hours.  So  long  as  the  muscles 
retain  their  contractility,  the  rigor  mortis  is  postponed. 

It  can  now  be  understood  that  whatever  produces  ex- 
haustion of  the  muscular  system,  must  thereby  hasten  the 
approach  of  cadaveric  rigidity.  Thus,  in  death  from  ex- 
hausting diseases,  as  in  phthisis  or  after  protracted  con- 
vulsions, or  when  the  muscular  system  becomes  exhausted 
by  over-exertion  and  fatigue,  as  is  seen  in  over-driven 
cattle,  or  animals  hunted  in  the  chase,  the  rigor  mortis 
shows  itself  early,  and  lasts  but  a  short  time ;  whereas,  if 
death  occurs  suddenly,  in  a  previously  healthy  person,  the 
rigidity  is  postponed  for  many  hours,  but  when  once  estab- 
lished, it  continues  for  a  much  longer  period.  Thus, 
according  to  Brown-Sequard,  the  bodies  of  decapitated 
healthy  criminals  were  observed  not  to  become  rigid  until 
after  the  lapse  of  ten  to  twelve  hours,  and  the  rigidity 
lasted  over  a  week,  even  in  warm  weather.  An  experiment 
of  the  above  named  physiologist  very  satisfactorily  proves 
this  statement.  Three  dogs  of  equal  size  were  poisoned 
with  strychnia  in  different  doses.  One  took  two  grains, 
and  died  almost  immediately.  The  second  took  half  a  grain, 
and  died  in  twelve  minutes.  The  third  took  one-fourth  of 
a  grain,  and  died,  after  protracted  convulsions,  in  twenty-one 
minutes.  In  the  first  animal,  whose  muscular  system  had 
been  least  exhausted  by  the  spasms,  rigor  mortis  did  not 
set  in  before  the  lapse  of  eight  hours,  and  the  duration  was 
nineteen  to  twenty  days.  In  the  second,  where  the  muscular 
exhaustion  was  greater,  the  rigidity  appeared  after  two  and 
a  half  hours ;  and  lasted  five  days.  In  the  third,  in  which 
the  muscular  exhaustion  was  the  most  protracted,  the  rigor 


38  MEDICAL  JURISPRUDENCE. 

mortis  was  developed  as  early  as  thirty  minutes,  and  lasted 
less  than  a  day. 

It  has  been  supposed  by  some,  that  the  rigor  mortis  does 
not  occur  in  the  bodies  of  persons  killed  by  lightning;  this, 
however,  is  a  mistake,  as  experience  abundantly  proves. 
Neither  is  it  interfered  with  by  the  previous  loss  of  blood 
by  hemorrhage.  It  is,  however,  dependent  on  temperature, 
at  least,  so  far  as  regards  the  duration,  which  is  shortened 
by  heat  and  prolonged  by  cold.  Bodies  submerged  in  cold 
water  retain  their  rigidity  for  a  considerable  length  of  time. 

When  a  joint  or  articulation  stiffened  by  rigor  mortis  (if 
this  be  complete),  is  forcibly  bent,  the  rigidity  is  destroyed. 
If,  however,  the  rigidity  is  incomplete,  it  will  be  resumed 
afterwards.  This  may  serve  to  distinguish  real  death  from 
certain  cases  of  catalepsy,  tetanus,  and  hysteria,  accompanied 
by  rigidity.  In  all  these  latter  cases,  the  stiffness  will  return, 
on  removal  of  the  opposing  force. 

Cadaveric  rigidity  is  riot  so  strong  as  voluntary  muscular 
contraction.  As  a  rule,  the  flexors  are  more  affected  than 
the  extensors,  so  that  the  limbs  are  generally  found  to  be 
slightly  bent  after  death. 

The  fact  that  the  involuntary  muscles  are  likewise  subject 
to  rigor  mortis  should  not  be  lost  sight  of,  as  it  might  lead 
to  an  error  as  to  the  true  pathological  state  of  an  organ  on 
making  an  autopsy.  The  heart,  for  instance,  may  be  found 
very  firmly  contracted  after  death  by  rigor  mortis ;  this 
might  be  mistaken  by  the  inexperienced,  for  a  true  contrac- 
tion of  the  organ,  the  result  of  previous  disease. 

Closely  connected  with  rigor  mortis,  if  not  indeed  a  modi- 
fication of  this  very  state,  is  the  condition  described  as 
cadaveric  spasm.  This  is  exhibited  in  the  bodies  of  persons 
who  have  died  by  sudden  and  violent  deaths,  in  whom  there 
seems  to  be  present  a  strong  will-power  just  prior  to  the 


CADAVERIC    LIVIDITY.  39 

death,  and  producing  strong  muscular  contraction  at  the 
moment  of  dissolution.  This  spasmodic  contraction,  more- 
over, appears  to  pass  at  once,  after  death,  into  the  usual 
rigor  mortis.  The  best  illustrations  of  this  peculiar  condi- 
tion are  afforded  in  those  cases  of  determined  suicides,  who 
have  taken  their  lives  by  shooting  themselves  with  a  pistol. 
Very  commonly  in  such  cases,  the  lethal  weapon  is  found 
so  tightly  grasped  in  the  dead  man's  hand,  as  to  require 
considerable  force  to  remove  it.  The  same  thing  is  some- 
times witnessed  in  the  bodies  of  drowned  persons  ;  fragments 
of  wood,  grass  and  weeds,  or  other  objects  which  had  been 
convulsively  seized  in  the  water  before  death,  being  found 
tightly  grasped  in  the  hands  ;  and  where  two  persons  have 
perished  together  by  drowning,  it  is  not  uncommon  to  find 
them,  after  death,  convulsively  clasped  in  each  other's  arms. 
To  a  similar  reason,  doubtless,  is  to  be  ascribed  the  singular 
and  striking  posture  which  the  bodies  of  soldiers,  on  a  field 
of  battle,  killed  in  conflict,  are  noticed  to  have  assumed  in 
the  act  of  dying.  Thus,  the  attitude  of  one  is  described  as 
"  resting  on  one  knee,  with  the  arms  extended,  in  the  act  of 
taking  aim ;  the  brow  compressed,  the  lips  clenched — the 
very  expression  of  firing  at  an  enemy  stamped  upon  his 
face,  and  fixed  there  by  death.  A  ball  had  struck  this  man 
in  the  neck.  Another  was  lying  on  his  back,  with  the  same 
expression,  with  his  arms  raised  in  a  similar  attitude,  the 
minnie  musket  still  grasped  in  his  hands  undischarged  " 
(Taylor). 

VI.  Cadaveric  Lividity,  or  Suggillation. — This  term  is 
applied  to  those  livid,  or  violet-colored  patches,  or  discolor- 
ations,  which  are  observed  upon  the  body  at  variable  periods 
after  death,  usually  after  several  hours.  It  is  the  result  of 
the  settling  of  the  blood  in  the  capillaries  by  gravitation. 


}()  MEDICAL   JURISPRUDENCE. 

Hence  it  is  noticed  in  the  most  dependent  parts  of  the  body, 
such  as  (supposing  it  to  be  lying  on  the  back)  the  back, 
sides,  and  under  surface  of  the  neck,  calves  of  the  leg,  and 
under  portions  of  the  thighs.  These  patches,  at  first  isolated, 
gradually  increase  in  size,  and  coalesce,  so  as  to  cover  a  larger 
surface  of  the  body.  Cadaveric  lividity  is  an  unquestionable 
"sign"  of  death.  It  makes  its  appearance  sometimes  much 
earlier  than  at  others ;  and  for  this  variation  no  very  satis- 
factory reason  can  be  assigned. 

The  most  important  point  connected  with  cadaveric 
lividity  is  not  to  confound  it  with  ecchymosis,  or  bruising, 
to  which  it  bears  a  considerable  resemblance.  Several  cases 
are  recorded  where  a  body  has  been  found  covered  with 
these  death  spots,  and  the  mistake  has  been  made  of  sup- 
posing them  to  be  bruises,  and  consequently  attributing  the 
death  to  violence  inflicted  during  life.  The  medical  exami- 
ner should  be  particularly  cautious  not  to  confound  them. 
Fortunately,  a  very  simple  test  will  settle  the  question.  If 
the  scalpel  be  drawn  through  a  suggillation,  no  blood  will 
flow  ;  the  most  that  will  be  observed  will  be  a  few  bloody 
points  or  specks,  arising  from  the  division  of  small  veins  of 
the  skin.  If,  however,  the  patch  be  ecchymosis  (where  the 
effused  blood  has  been  infiltrated  into  the  cellular  tissue), 
the  incision  will  either  be  followed  by  a  flow  of  blood,  or  else 
a  coagulum  will  be  seen.  Moreover,  whilst  the  ecchymosis 
is  sometimes  raised  above  the  level  of  the  surrounding  skin, 
the  cadaveric  stain  never  is.  These  spots  are  not  affected 
by  age,  sex,  or  constitution  ;  and  they  follow  upon  all  kinds 
of  death,  not  excepting  that  caused  by  hemorrhage. 

Suggillation  takes  place  in  the  internal  organs  as  well  as 
upon  the  surface  of  the  body,  producing  in  the  former, 
appearances  strongly  resembling  true  congestion  and  in- 
flammation, for  which   they  are  without   doubt  frequently 


PUTREFACTION.  41 

mistaken  by  the  inexperienced ;  and  as  it  may  be  a  matter 
of  considerable  consequence,  in  a  post-mortem  examination, 
not  to  confound  these  two  conditions,  the  examiner  should 
be  very  cautious  as  to  his  pathological  inferences  These 
internal  suggillations  are  also  termed  hypostatic  congestions; 
they  appear  chiefly  in  the  lungs,  brain,  kidneys  and  intestines. 
The  fact  that  they  invariably  occur  in  the  most  dependent 
portions  of  these  organs  should  be  suggestive  of  their  true 
origin,  since  a  real  congestion  or  inflammation  exhibits 
itself  either  throughout  the  whole  organ,  or  else  upon  its 
upper  surface  equally  with  the  lower  one.  Certainly,  it  is 
not  confined  exclusively  to  the  under  portion,  as  is  the 
suggillation.  When  it  occurs  in  the  intestines,  it  may  readily 
be  distinguished  from  true  inflammation,  by  simply  lifting  up 
several  folds  of  the  bowels,  when  the  horizontal  line,  which 
previously  had  marked  the  hypostatic  settling  of  the  blood, 
becomes  immediately  broken  and  disjointed,  whereas,  if  it  had 
been  a  real  congestion  or  inflammation,  the  redness  would 
have  involved  the  whole  circumference  of  the  intestines, 
and  there  would  have  been  no  broken  line  of  separation. 

In  the  brain,  hypostatic  congestion  might  be  mistaken,  by 
the  inexperienced,  for  one  form  of  apoplexy  ;  and  in  the  spinal 
cord  it  might  be  confounded  with  spinal  meningitis.  In  the 
heart,  true  suggillation  is  not  believed  to  occur;  but  this 
is  replaced  by  the  formation  of  post-mortem  clots,  called 
polypi  of  the  heart. 

SECTION    III. 

SIGNS  OF  DEATH  CONTINUED. — PUTREFACTION — EXTERNAL  AND  IN- 
TERNAL SIGNS. — ADIPOCERE. — MUMMIFICATION. — HOW  LONG  SINCE 
THE   DEATH  ? 

VII.  Putrefaction. — This  is  usually  regarded  as  the  most 
unequivocal  "  sign  "  of  death.     By  this  term  is  understood 
those  spontaneous  chemical  changes  undergone  by  all  dead 
3* 


42  MEDICAL   JURISPRUDENCE. 

animal  bodies,  resulting  in  the  elimination  of  fetid  gases. 
The  period  after  death  when  putrefaction  first  manifests 
itself  varies  considerably,  being  dependent  upon  several 
conditions,  some  of  which  are  connected  with  the  body 
itself,  and  others  extraneous  to  the  body. 

Among  the  conditions  inherent  to  the  body  itself  are: 
I.  Corpulence.  Fat  and  flabby  bodies  undergo  putrefaction 
more  speedily  than  thin  and  lean  ones,  doubtless  on  account 
of  the  preponderance  of  fluids  in  the  former.  2.  Age  and 
Sex.  For  the  same  reason  the  bodies  of  new-born  children, 
and  of  women  dying  in  child-bed  (according  to  Casper), 
decompose  more  rapidly  than  others,  especially  the  aged. 
3.  The  manner  of  death.  The  bodies  of  persons  dying  after 
an  exhausting  disease,  especially  if  the  vitality  of  the  blood 
has  been  impaired,  as  in  typhus  fever,  undergo  rapid  putre- 
faction ;  also  after  death  from  certain  poisons,  and  especially 
poisonous  gases,  as  coal  gas  and  sulphuretted  hydrogen  ; 
also  from  suffocation  from  smoke,  and,  indeed,  from  suffoca- 
tion generally.  Putrefaction  is  also  accelerated  in  bodies 
that  have  been  much  bruised  and  mangled  by  machinery, 
or  railway  and  other  accidents  ;  but  we  must  except  those 
cases  where  the  body  remains  protected  from  atmos- 
pheric influences,  as  when  buried  beneath  ruins,  etc.  On 
the  other  hand,  the  process  is  retarded  in  death  by  alcohol, 
phosphorus,  sulphuric  acid,  arsenic,  and  some  narcotic 
poisons.  The  antiseptic  properties  of  alcohol  and  arsenic 
are  well  understood.  The  action  of  sulphuric,  and  doubt- 
less the  other  mineral  acids,  is  probably  to  neutralize  the 
ammonia  as  fast  as  it  is  formed,  rather  than  actually  to 
retard  the  process  of  putrefaction.  Admitting  all  the  above 
conditions,  and  giving  them  due  allowance,  there  are  doubt- 
<>ther  causes,  as  yet  unknown  to  us,  which  influence  the 
rapidity  of  putrefaction.     Casper  adduces   the  instance 


PUTREFACTION.  43 

four  men,  all  of  about  the  same  age  and  general  physique, 
and  all  suddenly  killed  in  a  riot.  They  were  all  buried 
at  the  same  time,  and  in  precisely  similar  coffins  and 
graves ;  yet,  on  subsequent  examination,  the  progress  of 
decomposition  in  the  several  bodies  was  found  to  vary  very 
considerably. 

The  external  or  objective  conditions  influencing  putre- 
faction are  air,  moisture  and  temperature.  The  influence  of 
the  atmosphere  upon  animal  decomposition  is  well  under- 
stood, and  is  familiarly  witnessed  in  the  preservation  of 
meats  and  other  articles  of  food  in  hermetically  sealed  cans, 
for  an  indefinite  length  of  time.  It  is  undoubtedly  the  oxy- 
gen of  the  atmosphere  that  is  the  destructive  agent,  since 
flesh  may  be  preserved  in  nitrogen  (the  other  constituent 
of  air)  for  a  long  period.  Moreover,  the  oxygen  must 
be  in  a  free  state,  as  it  exists  in  the  atmosphere,  and  not  in 
a  compound,  as  in  carbonic  acid  gas,  or  nitrous  and  nitric 
oxide.  These  gases  do  not  act  as  decomposing  agents. 
The  influence  of  atmospheric  air  is  not  limited  to  the  mere 
supply  of  oxygen,  but  it  modifies  putrefaction  according  to 
the  amount  of  moisture  it  contains.  For  this  reason,  per- 
fectly dry  air,  such  as  that  of  the  arid  deserts  of  Arabia  and 
Africa,  by  its  rapid  desiccating  properties,  arrests  putrefaction ; 
the  body  speedily  losing  its  fluids  by  evaporation,  dries,  and 
shrivels  up  into  a  sort  of  mummy.  The  effects  of  an  entire 
exclusion  of  air  in  retarding  the  process  of  decomposition 
in  a  human  body  are  witnessed  in  the  burial  of  royal  per- 
sonages in  leaden  coffins  hermetically  sealed,  and  these 
afterwards  enclosed  in  marble  sarcophagi.  When  these 
have  been  opened,  hundreds  of  years  subsequently,  the 
remains  have  been  found  in  a  remarkable  state  of  preserva- 
tion. On  the  other  hand,  bodies  naked,  or  but  slightly 
clothed,  and   buried   in  pine   coffins,  which  soon  decay,  and 


44  MEDICAL   JURISPRUDENCE. 

in  shallow  graves,  to  which  the  air  has  easy  access,  will 
undergo  very  speedy  decomposition.  The  nature  of  the 
soil,  and  the  depth  of  the  grave  also  materially  influence  this 
process.  Thus,  a  loose,  sandy  soil  and  a  shallow  grave  favor 
it,  by  the  ready  admission  of  air,  whilst  one  of  a  stiff,  clayey 
nature,  and  a  deep  grave  would  retard  it,  for  the  opposite 
reason.  From  recent  observations,  it  is  highly  probable 
that  the  real  cause  of  atmospheric  influence  upon  decompo- 
sition is  the  presence  of  the  bacteria  or  baccilli  which  float 
in  such  myriads  in  the  air,  and  which  find  their  peculiar 
habitat  in  dead  animal  matter. 

The  effect  of  moisture  as  an  agent  in  animal  putrefaction 
is  to  aid  it,  by  favoring  solution.  The  different  tissues  and 
organs  of  the  body  undergo  decomposition  just  in  propor- 
tion to  the  amount  of  fluids  they  contain.  In  this  respect 
the  brain  of  the  young  infant,  and  the  eye  contrast  widely 
Avith  the  bones  and  teeth.  The  human  body  contains  eight- 
tenths  of  its  whole  weight  in  fluids;  hence  its  great  tendency 
to  putrefy  after  death.  The  bodies  of  drowned  persons 
undergo  rapid  decomposition,  unless  the  water  be  extremely 
cold.  In  the  latter  case,  the  low  temperature  acts  as  a 
preservative.  Likewise,  bodies  thrown  into  dungheaps  and 
cesspools  speedily  putrefy,  from  a  similar  cause,  although 
the  process  may  also  be  aided  by  the  warmth  of  these  media. 
If  a  body  be  completely  deprived  of  its  fluids  by  drying, 
putrefaction  is  arrested,  as  was  remarked  under  the  preceding 
head. 

The  influence  of  temperature  as  an  agent  in  putrefaction 
is  very  manifest.  The  temperature  most  favorable  to  this 
process  is  that  between  yo°  and  ioo°  F.  It  commences, 
however,  as  low  as  500,  but  it  is  completely  arrested  at  320, 
below  which  the  body  becomes  frozen,  and  also  at  21 2°, 
when  it  becomes  desiccated  by  complete  loss  of  its  fluids, 


PUTREFACTION.  45 

through  evaporation.  As  is  well  known,  an  animal  body 
may  be  preserved  for  an  indefinite  period  if  completely  frozen 
in  snow  or  ice.  It  is  recorded  that  the  body  of  a  Russian 
nobleman  that  had  been  buried  in  the  frozen  soil  of  Siberia,  on 
being  exhumed,  after  a  period  of  ninety-two  years,  was  found 
in  a  state  of  almost  perfect  preservation.  On  the  other  hand, 
the  effects  of  a  high  temperature  as  a  preservative  are  wit- 
nessed in  the  mummies  of  Egypt  and  adjacent  countries. 
In  this  case,  however,  the  dryness  of  the  atmosphere  as  well 
as  the  high  temperature  assists  in  the  preservation. 

The  effect  of  temperature  in  the  process  of  putrefaction  is 
familiarly  shown  in  the  influence  of  the  seasons.  Thus,  in 
summer  a  body  will  decompose  very  much  sooner  than  in 
winter — a  circumstance  that  should  not  be  forgotten  when 
giving  an  opinion  respecting  the  date  of  death  in  an  unknown 
case.  According  to  Casper,  the  relative  rapidity  of  decom- 
position in  bodies  exposed  to  the  air,  kept  in  cold  water,  and 
buried  in  the  earth,  is  in  the  ratio  of  one,  two  and  eight ;  that 
is,  putrefaction  advances  as  rapidly  in  one  week  in  the  open 
air,  as  in  two  weeks  in  the  water,  and  in  eight  weeks  in  the 
earth  (average).  It  may  here  be  remarked  that  a  body 
floating  near  the  top  of  the  water  will  decompose  more 
rapidly  than  when  at  the  bottom ;  and  when  taken  out  of 
the  water  and  exposed  to  the  air,  the  putrefaction  will  be 
far  more  rapid  than  if  left  in  the  water. 

External  signs  of  Putrefaction. — The  following  is  the 
order  generally  observed,  externally,  in  the  progress  of 
putrefaction  of  bodies  exposed  to  the  open  air.  In  one  to 
three  days  in  summer  (three  to  six  in  winter),  there  first 
appears  a  greenish,  or  yellowish-green  spot  upon  the 
abdomen,  three  or  four  inches  in  diameter,  accompanied 
with  the  peculiar  odor  of  putrefaction.  The  eyeball  becomes 
soft  and  yielding  within  the  same  period.     In  a  few  days 


46  MEDICAL   JURISPRUDENCE. 

more,  this  greenish  discoloration  has  spread  generally  over 
the  whole  body,  first  in  spots,  which  subsequently  gradually 
coalesce.  Dirty  red  streaks  now  show  themselves 
throughout   the  surface,  marking  the  course  of  the  blood 

fc>  '  o 

vessels.  In  ten  or  fifteen  days  (in  warm  weather),  the 
epidermis  begins  to  loosen,  forming  blebs  or  blisters  con- 
taining fluid.  Gases  now  begin  to  form  in  the  chest  and 
abdomen,  causing  these  cavities  to  swell  out  greatly.  The 
eyeballs  protrude,  from  the  same  cause;  the  face  is  swollen; 
the  features  so  much  bloated  as  no  longer  to  be  recog- 
nizable. In  two  or  three  weeks,  the  blebs  of  the  cuticle 
may  have  burst  open;  maggots  appear;  the  formation  of 
gases  increases,  so  that  the  body  is  enormously  swollen.  If 
it  be  now  punctured,  the  gas  which  is  emitted  will  frequently 
take  fire  on  the  approach  of  a  flame  (carburetted  hydrogen). 
Other  gases  are  likewise  formed,  the  result  of  animal 
decomposition,  as  carbonic  acid,  sulphuretted  hydrogen, 
phosphoretted  hydrogen,  nitrogen,  and  ammonia.  The 
nails  now  loosen ;  and  in  the  further  progress  of  putrefac- 
tion the  cavities  burst  open,  and  discharge  their  contents ; 
the  softened  flesh  dissolves  off  from  the  bones,  which  now 
become  exposed,  and  ultimately  fall  apart  from  the  skeleton. 
The  sexes  cease  to  be  distinguishable,  except  perhaps  by 
the  discovery  of  a  uterus,  which  appears  to  be  the  very  last 
organ  to  yield  to  putrefaction. 

The  above  description  is  only  a  very  general  and  average 
one,  since  the  process  of  the  external  putrefaction  of  the 
body  is  so  very  variable,  and  is  influenced  by  so  many 
circumstances,  all  of  which  are  not  yet  fully  understood. 

Internal  signs  of  Putrefaction. — The  order  in  which  the 
internal  organs  of  the  body  undergo  decomposition,  being 
more  regular  as  to  time,  affords  a  rather  better  criterion  as 
to  the  time  of  death.     The  first  organ  of  the    body  that 


ORDER    OF    PUTREFACTION.  47 

shows  signs  of  decomposition  after  death  is  the  lining 
membrane  of  the  windpipe  (larynx  and  trachea) ;  this 
assumes  a  dirty  red  coloration  simultaneously  with  the 
appearance  of  the  greenish  spot  upon  the  abdomen.  That 
this  is  not  the  result  of  injection  of  the  blood  vessels  is 
proven  by  the  microscope.  In  the  earliest  stage  of  death, 
this  membrane  is  always  very  pale,  except  when  the  death 
has  been  caused  by  laryngitis,  or  suffocation.  The  ex- 
aminer should  be  cautioned  not  to  mistake  this  mark  of 
putrefaction  for  congestion.  Very  soon  after  this  stage  of 
redness,  it  becomes  of  an  olive-green  color,  and  the  rings 
of  the  trachea  separate,  and  it  all  falls  to  pieces  and  dis- 
appears. 

The  next  (2)  organ  to  decompose  is  the  brain  of  young 
infants.  The  reason  of  this  lies,  of  course,  in  the  fact  that 
this  organ  at  such  an  early  age  is  so  very  delicate,  and  is 
so  little  protected,  by  its  bony  covering,  from  the  outer  air. 
When  decomposing,  it  changes  into  a  soft,  rosy,  pulpaceous 
mass,  and  flows  away  out  of  the  smallest  openings. 

Then  follows  (3)  the  stomach.  This  organ  is  among  the 
earliest  to  putrefy  after  death.  The  decomposition  first 
manifests  itself  in  discolorations  of  the  fundus,  together 
with  the  formation  of  dirty  red  spots  in  the  posterior 
portion  of  the  fundus,  owing  to  hypostatic  congestion. 
These  spots  soon  ramify,  and  cover  the  whole  lining  mem- 
brane. There  is  great  risk  of  mistaking  these  spots  for 
signs  of  congestion  or  inflammation  due  to  irritant  poison- 
ing. The  examiner  should  be  specially  cautioned  on  this 
point,  as  it  is  often  impossible  to  distinguish  them  apart  by 
a  merely  ocular  inspection.  It  is  quite  certain  that  a  post- 
mortem redness  of  the  mucous  membrane  of  the  stomach 
cannot  of  itself  prove  a  case  of  poisoning.  In  the  further 
progress    of  putrefaction,   the    stomach    softens,  the    spots 


48  MEDICAL   JURISPRUDENCE. 

become  greenish  and  gray ;  then  black,  with  dark  red 
streaks  (veins)  running  through  them.  It  is  finally  con- 
verted into  a  pulpaceous  mass,  and  ceases  to  be  recognized. 

Next  to  the  stomach,  the  intestines  (4)  follow  in  the  pro- 
cess of  decomposition.  They  become  discolored  very  much 
as  in  the  case  of  the  stomach ;  then  they  burst  open,  and 
discharge  their  contents,  forming  a  greasy  mass  which  finally 
disappears. 

The  spleen  (5)  comes  next  in  the  order  of  putrefaction. 
If  not  diseased  at  the  time  of  death,  it  may  retain  its  integ- 
rity for  two  or  three  weeks.  It  first  assumes  a  dark  red 
color,  then  a  greenish-blue,  then  becomes  soft  and  pulpy,  so 
that  its  substance  can  be  rubbed  down  with  the  handle  of 
the  scalpel. 

Following  the  spleen,  the  omentum  and  mesentery  (6)  are 
the  organs  next  to  decay.  If  there  is  not  much  fat  con- 
nected with  them,  they  will  rapidly  dry  up,  and  disappear. 

The  liver  (7)  resists  putrefaction  for  a  considerable  time  after 
death — in  adults  for  several  weeks.  In  infants  it  decomposes 
earlier.  It  first  becomes  of  a  green  color,  then  black  ;  then 
softens,  shrivels,  and  finally  disappears.  In  case  of  death  by 
arsenic  poisoning,  the  liver  would  be  likely  to  resist  decom- 
position for  a  very  considerable  time,  in  consequence  of  the 
affinity  of  that  organ  for  arsenic,  which  would  exercise  its 
preservative  influence  over  it. 

The  brain  of  adults  (8)  does  not  begin  to  show  signs  of 
putrefaction  until  the  end  of  the  fourth  or  fifth  week,  and 
sometimes  even  later.  The  process  commences  at  the  base, 
which  softens  and  becomes  bluish-green,  and  gradually 
progresses  upward,  and  then  inward.  If  the  brain  has 
been  injured,  as  by  a  depressed  bone,  or  by  a  gunshot 
wound,  it  is  affected  earlier. 

Next  in  order  is  the  heart  (9).     This  is  one  of  the  toughest 


ORDER    OF    PUTREFACTION.  49 

of  all  the  organs.  The  softening  here  begins  in  the  columnar 
carneae,  and  progresses  outward  toward  the  walls  of  the 
organ,  which  finally  deliquesce  into  an  unrecognizable 
mass. 

It  is  remarkable  that  the  lungs  (10),  which  are  very  soft 
organs,  and  are  so  nearly  connected  with  the  outward  air, 
should  resist  putrefaction  so  long.  These  organs  are  often 
found  quite  sound  for  weeks  after  death,  provided  they  were 
healthy  and  uninjured  at  dissolution.  The  first  evidence  of 
their  decomposition  is  the  formation  of  little  bladders  of  air 
in  the  sulci,  between  the  lobes,  on  the  under  surface,  looking 
like  a  string  of  beads.  These  increase  rapidly,  the  lung 
structure  turning  first  green,  then  black,  and  finally  softening 
and  disappearing. 

The  kidneys  (i  i)  follow  the  lungs.  They  become  reddish- 
brown,  and  soften;  then  they  assume  a  greenish-black  color, 
and  soften  and  disappear.  Next  in  order  (12)  follow  the 
urinary  bladder  and  oesophagus.  Next  (13)  the  pancreas, 
which,  though  a  soft  organ,  and  located  near  the  stomach, 
is  among  the  last  to  decompose.  Then  follow  (14)  the 
diaphragm  and  the  arteries  ;  the  tissue  of  the  latter  resisting 
putrefaction  while  everything  else  around  them  has  fallen 
into  a  shapeless  mass. 

Last  of  all,  according  to  Casper,  is  the  uterus  (15),  which 
has  been  found  to  retain  its  identity  at  the  end  of  seven 
months  after  death.  This  fact  is  of  great  medico-legal 
importance,  where  the  question  arises  of  the  possibility  of 
pregnancy. 

The  above  description  of  the  progress  of  putrefaction,  both 
external  and  internal,  of  the  human  body  is  taken  chiefly 
from  Pr.of.  Casper's  work  on  Forensic  Medicine,  translated 
and  published  by  the  Sydenham  Society.  It  is  intended  to 
represent  the  average,  both  as  regards  appearance  and  time. 


50  MEDICAL   JURISPRUDENCE. 

As  already  stated,  there  may  be  considerable  deviations  from 
the  order  laid  down,  depending  upon  a  variety  of  circum- 
stances. 

Saponification,  or  Adipocere. — It  sometimes  happens,  in 
the  course  of  the  putrefaction  of  the  body,  that  this  process 
is  interfered  with  under  peculiar  circumstances,  and  gives 
place  to  a  new  condition,  known  as  the  saponification  of  the 
body,  or  the  production  of  adipocere.  This  remarkable 
condition  was  first  observed  by  Fouroroy,  who  discovered, 
during  the  removal  of  human  remains  from  one  of  the 
public  cemeteries  of  Paris,  that  a  number  of  the  bodies, 
instead  of  undergoing  ordinary  putrefaction,  had  been  con- 
verted into  a  new  substance,  which  he  styled  adipocere, 
from  its  resemblance  to  a  combination  of  fat  (adeps)  and 
wax  (ccra). 

This  adipocere  has  an  unctuous  feel,  somewhat  like 
spermaceti,  and  is  of  a  whitish,  discolored  appearance.  By 
the  analysis  of  M.  Chevreul,  jt  was  found  to  be  an  ammo- 
niacal  soap — a  compound  of  stearic  and  oleic  acids,  united 
with  ammonium.  In  the  course  of  putrefaction,  the  fatty 
acids  of  the  body  combine  with  the  ammonia,  which  is  the 
result  of  the  decomposition  of  the  nitrogenized  tissues.  It 
is  interesting  to  inquire  what  are  the  conditions  under  which 
this  singular  process  of  saponification  replaces  the  ordinary 
decomposition  of  the  body.  The  presence  of  water  is  essen- 
tial to  it.  It  only  occurs  in  bodies  that  have  been  buried  in 
wet,  or  very  moist  soil.  It  never  happens  to  those  interred 
in  a  loose,  or  sandy  soil.  It  is  frequently  the  case  that  when 
the  grave,  after  burial,  fills  with  water,  the  contained  body- 
is  converted  into  adipocere.  The  same  thing  takes  place  in 
bodies  which  remain  in  the  water  for  a  certain  length  of 
time. 


ADIPOCERE.  51 

The  composition  of  adipocere  is  not  always  precisely  the 
same.  Its  base  may  consist  of  either  ammonia  or  lime. 
The  latter  takes  the  place  of  the  former,  whenever  the  sapo- 
nified substance  remains  for  any  considerable  time  in  water 
containing  any  salt  of  lime.  This  was  determined  experi- 
rr.ently  by  Orfila,  who  placed  an  ammonium  adipocere  in  a 
solution  of  sulphate  of  lime;  he  found  that  after  a  time  it 
had  been  changed  into  the  oleo-stearate  of  lime.  Adipocere 
is  insoluble  in  water,  but  partially  soluble  in  alcohol.  It 
takes  fire  and  burns  at  a  temperature  of  about  21 2°  K., 
emitting  a  greasy  smell.  It  contains  a  coloring  matter,  and 
an  odorous  and  a  bitter  principle.  Its  odor  resembles  some- 
what that  of  musty  cheese. 

From  the  fact  that  if  a  body  remain  immersed  in  the 
water  for  any  length  of  time  it  is  likely  to  be  changed  into 
adipocere,  it  becomes  an  important  medico-legal  question 
to  establish  the  period  necessary  for  this  conversion.  De- 
vergie  ascertained  that  the  body  of  a  new-born  child  was 
more  or  less  changed  into  adipocere  after  remaining  in  the 
water  for  five  or  six  weeks.  We  see  at  once  the  value  of 
this  knowledge  to  the  legal  physician,  since  the  bodies  of  new- 
born infants  are  frequently  thrown  into  wells,  privies  and 
cesspools,  by  their  unnatural  mothers.  If  such  a  body  be 
found  under  such  circumstances,  with  the  process  of  saponi- 
fication only  just  begun,  it  is  tolerably  certain  that  it  could 
not  have  been  long  in  the  water,  and  vice  versa.  According 
to  the  same  distinguished  authority,  an  adult  body  requires 
an  immersion  in  water  for  one  year,  before  the  conversion  is 
complete;  and  when  it  is  buried  in  wet  earth,  a  period  of  three 
years  may  elapse  before  the  change  is  completely  effected. 

An  adipocerous  body  is  always  heavier  than  an  ordinary 
one,  because  the  adipocere  is  more  weighty  than  the  original 
fat. 


52  MEDICAL   JURISPRUDENCE. 

Mummification. — This  constitutes  another  process  by 
which  the  ordinary  putrefaction  of  the  body  is  interfered 
with.  By  mummification  we  understand  the  complete  desic- 
cation, or  drying  up  of  the  body.  A  mummified  body  is  the 
result  either  of  burial  in  an  arid  and  sandy  soil  of  hot  coun- 
tries, such  as  those  of  Arabia  and  Egypt,  or  of  the  exposure 
of  the  body  to  a  constantly  cold  and  dry  atmosphere — where, 
for  instance,  it  is  placed  in  a  vault,  through  which  a  constant 
stream  of  dry,  cold  air  is  pouring.  Such  a  condition  of 
things  is  found  at  the  Hospice  of  St.  Bernard,  in  Switzerland. 
In  the  charnel  house  attached  to  this  establishment,  the 
bodies  of  those  who  have  perished  in  the  snows  are  placed. 
The  atmosphere  is  so  constantly  cold  and  dry,  that  the  flesh 
and  fat  completely  dry  up.  It  is  quite  impossible,  from  the 
mere  inspection  of  a  mummy,  to  venture  an  opinion  as  to 
the  length  of  time  that  has  elapsed  since  death.  Some  of 
the  Egyptian  mummies  are  from  two  to  three  thousand 
years  old,  as  is  shown  by  the  inscriptions  upon  their  burial 
cases. 

There  are  certain  agents  which  retard,  and  others  which 
promote,  decomposition.  The  former  comprise  the  various 
antiseptics.  Lime,  although  popularly  supposed  to  hasten 
putrefaction,  in  reality  retards  it,  as  is  shown  by  a  simple 
experiment  of  Dr.  John  Davy,  who  buried  a  piece  of  raw 
flesh  that  had  been  first  covered  over  with  powdered  lime. 
It  continued  sound  much  longer  than  another  piece  that  was 
buried  without  the  lime.  No  doubt,  the  lime  here  served 
the  purpose  of  secluding  the  atmospheric  air.  The  strong 
acids  and  alkalies,  although  they  do  not  hasten  putrefaction, 
promote  dissolution  through  chemical  action,  and  in  this 
way  they  aid  in  the  removal  of  a  body. 

The  period  and  method  of  Interment  very  materially  influ- 
ence the  rapidity  of  putrefaction.     Thus,  if  decomposition 


HOW    LONG    SINCE    THE    DEATH  ?  53 

has  already  set  in  before  burial,  this  action  will  progress  far 
more  rapidly  afterwards,  than  in  a  body  which  was  interred 
before  putrefaction  was  begun.  Again,  the  depth  of  the 
grave  and  the  nature  of  the  soil  exercise  a  very  marked 
influence  on  the  subsequent  decomposition  of  the  body,  as 
already  pointed  out.  Finally,  the  cause  of  death — as  from 
a  wasting  disease,  more  especially  when  the  blood  has  been 
deteriorated,  as  in  typhus  fever,  etc. — will  materially  influ- 
ence the  subsequent  rapidity  of  the  decomposition  of  the 
body. 

II.  Having  disposed  of  the  first  medico-legal  question — 
is  the  death  real  or  apparent  ?  we  may  consider  the  second 
important  query — how  long  a  time  has  elapsed  since  the 
death?  This  is  to  be  determined,  in  the  absence  of  direct 
evidence,  solely  by  attending  to  the  different  "  signs  "  or 
phenomena  of  death  already  described.  The  inferences  may 
be  drawn,  first,  from  the  signs  occurring  before  putrefaction, 
secondly,  from  those  occurring  after  it. 

( i )  Inferences  from  the  signs  exhibited  before  putrefaction. — 
If  the  body  is  only  slightly  cold,  and  rigidity  is  just  com- 
mencing about  the  jaws,  the  eyes  glazed,  and  the  eyeballs 
sunken ;  death  has  occurred,  most  probably,  from  a  quarter 
of  an  hour  to  four  or  five  hours.  (The  inference  can  never 
be  more  than  approximative.) 

Suppose  the  body  to  be  perfectly  cold  (externally)  and 
rigid  throughout:  it  has  probably  been  dead  from  twelve 
hours,  to  three  or  four  days.  If  rigidity  is  complete  over 
the  body,  and  cadaveric  lividity  (suggillation)  is  manifested 
over  the  surface,  death  has  probably  occurred  from  one  to 
four  days. 

The  importance  of  attending  to  the  above  phenomena,  by 
the  medical  jurist,  is  shown  by  a  case  mentioned  by  Taylor, 


54  MEDICAL    JURISPRUDENCE. 

which  occurred  in  London  some  years  ago.  A  man  named 
Gardiner  was  convicted  and  transported  for  killing  his  wife. 
The  woman  was  discovered,  with  her  throat  cut,  at  8  o'clock 
in  the  morning.  She  was  very  rigid  throughout  the  upper 
part  of  her  body,  and  the  whole  body  was  cold.  The 
prisoner  was  able  to  prove  an  alibi  between  the  hours  of  4 
and  8  A.  iff.,  and  his  counsel  endeavored  to  show  that  the 
post-mortem  coldness  and  the  partial  rigidity  might  have 
developed  within  four  hours,  which,  if  true,  would  have 
exculpated  the  accused.  But  this  point  was  very  properly 
overruled  by  the  mass  of  medical  testimony  to  the 
contrary. 

(2)  Inferences  after  putrefaction. — Suppose  the  body 
exhibits  the  greenish  discoloration  on  the  abdomen,  the 
peculiar  odor  of  putrefaction ;  the  rigor  mortis  has  passed 
off,  and  the  body  is  cold  but  pliant:  death  has  occurred  from 
one  to  three  days,  in  summer,  and  from  three  to  six  or 
eight  days,  in  winter. 

If  the  greenish-yellow  discoloration  extends  more  or  less 
over  the  whole  surface,  together  with  greenish-brown  stains, 
and  dark  red  lines  over  various  parts,  along  with  relaxation 
of  the  sphincter  ani  muscle,  it  must  have  been  dead  from 
eight  to  ten  days,  in  summer,  and  from  ten  to  twenty  days, 
in  winter. 

If  blebs  are  found  over  the  skin,  and  some  of  them 
opened,  with  maggots  in  the  muscles ;  if  the  body  is  green 
all  over,  and  the  chest  and  abdomen  are  enormously  dis- 
tended ;  the  nails  loose  or  falling  out ;  the  color  of  the  eyes 
not  recognizable;  the  features  very  much  swollen,  then  the 
death  must  have  occurred  from  two  to  three  weeks,  in 
summer,  or  from  four  to  five  weeks,  in  winter. 

If  the  chest  and  abdomen  have  burst  open  and  discharged 
their  contents,  and  some  of  the  bones  are  denuded  of  their 


INFERENCES    AS    TO    TIME    OF    DEATH.  55 

fleshy  coverings;  the  eyes  enormously  swollen;  the  body 
has  been  dead,  probably,  from  two  to  four  months. 

The  above  "  inferences,"  it  will  be  remembered,  are  only 
approximative,  as  already  stated.  They  cannot  be  positive 
under  any  circumstances;  and,  moreover,  they  are  predicated 
on  the  supposition  that  the  body  under  examination  has  not 
been  buried,  but  exposed  to  the  action  of  the  atmosphere. 
It  is  important  that  the  legal  physician  should  avoid  giving 
a  very  positive  opinion  on  this  question,  as  it  must,  at  best, 
be  but  conjectural,  and  dependent  on  so  many  contingencies. 


56  MEDICAL   JURISPRUDENCE, 


CHAPTER    III. 

MEDIO  >-LEGAL  INVESTIGATE  >NS.— THE  POST-MORTEM. 

RESPONSIBILITY  INVOLVED  IN  MAKING  THE  POST-MORTEM. — GENERAL 
ACCURACY  AND  .METHOD  NECESSARY. — EXAMINATION  OF  THE  SUR- 
ROUNDINGS OF  THE  BODY. — EXTERNAL  EXAMINATION  OF  THE 
BODY.— INTERNAL  EXAMINATION  OF  THE  BODY. — DETAILS  OF  THE 
EXAMINATION. — MEASUREMENTS    AND    WEIGHTS. — NOTES. 

The  physician  who  undertakes  to  make  a  post-mortem 
examination  in  a  medico-legal  case,  assumes  a  very  serious 
responsibility.  He  should,  therefore,  be  fully  prepared  to 
meet  the  various  contingencies  that  may  present  themselves, 
and  he  should  execute  his  work  so  thoroughly  as  to  leave 
no  cause  for  subsequent  regret.  He  should,  moreover,  per- 
form his  duty  with  strict  impartiality,  unbiassed  by  prejudice, 
and  untrammeled  by  fear  or  favor.  Not  only  should  the 
examiner  be  an  expert  anatomist  and  pathologist,  but  he 
should  also  be  a  close  and  careful  observer  of  all  the  sur- 
rounding circumstances  that  might  throw  light  upon  the 
case. 

In  all  cases  where  dispute  is  likely  to  arise,  it  is  advisable 
to  have  two  examiners,  so  as  to  avoid  an  ex  parte  appear- 
ance ;  and  the  suspected  person  should  be  represented  by 
a  friend  of  his  own  selection.  The  examination  should 
always,  if  possible,  be  made  by  daylight,  since  artificial  light 
might  conceal  certain  shades  of  color  which  it  might  be 
important  to  recognize,  such  as  the  stains  of  nitric  acid. 

Where  a  chemical  or  microscopical  investigation  becomes 
necessary,  the  parts  required  should  be  carefully  put  aside 
for  as  early  a  subsequent  examination  as  possible. 

The  examination  should  always  be   cxliaitstive — leaving 


THE    POST-MORTEM.  57 

nothing  undone — so  that  the  examiner  may  be  able  to  testify 
accurately  as  to  the  cause  of  death.  For  example,  the  dis- 
covery of  a  disease  of  the  heart  (a  sufficient  cause  of  death) 
should  not  preclude  an  examination  of  the  lungs  and  brain, 
in  each  of  which  the  real  cause  of  the  death  may  be  found 
located.  So,  also,  the  finding  of  poison  in  the  stomach  may 
co-exist  with  a  ruptured  aneurism,  or  a  clot  in  the  brain. 
The  examination,  moreover,  should  be  conducted  according 
to  method,  and  all  the  details  carefully  recorded  in  a  note- 
book. 

The  post-mortem  should  be  made  as  early  as  possible 
after  the  first  day  subsequent  to  the  death.  But  it  should 
never  be  declined  on  account  of  the  interval  that  may  have 
elapsed,  nor  even  if  the  body  be  in  a  state   of  putrefaction. 

The  surroundings  should  first  claim  attention,  such  as  the 
locality  where  the  body  was  discovered,  as  this  may  aflbrd 
a  clue  to  the  criminal,  especially  in  a  case  of  infanticide. 
Sometimes  the  body  has  been  dragged  by  the  murderer  to 
a  distant  spot,  or  the  victim  may  have  followed  his  assailant 
after  receiving  the  blow,  and  died  at  a  distance.  The 
presence  of  footmarks  near  by  should  be  noted,  together 
with  their  direction;  evidences  of  struggling \  as  denoted  by 
the  condition  of  the  grass,  or  dust,  or  mud  in  the  road ;  the 
presence  of  any  weapon,  or  other  missile.  If  in  a  room,  the 
position  of  the  body  in  reference  to  articles  of  furniture,  to 
any  weapon,  to  glasses,  cups,  bottles,  etc.,  from  which  poison 
may  have  been  taken.  It  is  also  advisable  to  make  a  sketch, 
or  rough  drawing  of  the  locality. 

As  regards  the  body  itself,  the  examiner  should  note  its 
exact  position  when  found :  this  is  especially  important  if 
death  was  caused  by  a  wound.  The  clothes  should  be  care- 
fully examined,  whether  torn  or  cut;  whether  marked  by 
blood-stains,  or  by  any  acid;  if  stabbed,  whether  the  cuts 
4 


MEDICAL   JURISPRUDENCE. 

correspond  with  the  wounds  on  the  body.  The  clothes 
should  then  be  removed,  and  the  whole  body  minutely 
inspected.  It  should  also  now  be  identified,  if  possible. 
Notes  should  be  made  of  the  sex,  height,  weight,  age  and 
general  development;  of  scars  and  other  marks;  abnormali- 
ties ;  blood,  seminal  and  other  stains ;  the  color  of  the  skin,  and 
condition  of  the  eyes  and  teeth;  the  temperature  and  rigidity 
of  the  body;  the  degree  of  putrefaction ;  lividity  and  ecchy- 
moscs ;  matters  flowing  from  the  nose  and  mouth;  state  of 
the  tongue  ;  expression  of  the  countenance.  The  hands  should 
be  inspected,  to  ascertain  if  they  hold  a  weapon — whether 
loosely  or  tightly  grasped;  or  if  portions  of  hair  or  clothing 
are  firmly  held  (denoting  a  struggle);  whether  stained  with 
blood,  or  blackened  by  powder  (the  latter  indicating  fire- 
arms); the  presence  or  absence  of foreign  bodies  in  the  nose, 
mouth,  anus  and  vagina  should  also  be  noticed. 

All  wounds  should  be  carefully  examined,  as  to  depth, 
extent  and  direction,  and  whether  they  suit  the  weapon  that 
may  be  found  near  by;  the  condition  of  their  edges,  as 
indicating  whether  recent  or  not;  marks  of  inflammation, 
suppuration  or  gangrene ;  whether  any  foreign  body  be 
present,  as  a  ball,  fragments  of  clothing  etc.  The  scalpel 
may  be  used,  if  necessary,  to  enlarge  the  wound,  with  care 
not  to  interfere  with  its  original  character.  If  there  is 
contusion  without  solution  of  continuity,  the  examiner 
should  not  fail  to  look  for  internal  injuries. 

In  fractures  and  luxations,  notice  their  condition,  and  that 
of  the  surrounding  parts.  In  case  of  burns ,  observe  their 
degree  and  extent;  whether  merely  inflamed  or  vesicated, 
and  the  state  of  the  adjacent  parts. 

In  females,  examine  the  genital  organs,  in  cases  of  rape, 
pregnane};,  and  recent  delivery. 

In   newborn  children,  ascertain   their  length  and  weight, 


INTERNAL  EXAMINATION  OF  THE  BODY.        59 

condition  of  the  hair,  nails,  membrana  pupillaris  and  genital 
organs,  condition  of  the  umbilical  cord.  The  question  of  a 
live-birth  will  be  a  subject  for  future  investigation. 

The  Internal  Examination  of  the  Body-. — The  following 
order  should  be  observed  : — 

(i)  The  Head. — After  a  careful  external  examination  for 
wounds  or  injuries  (for  which  the  hair  may  have  to  be  re- 
moved), the  scalp  should  be  separated  by  an  incision  made 
across  it  from  ear  to  ear,  down  to  the  bone ;  it  should  then 
be  everted  in  both  directions,  so  as  to  expose  the  skull. 
Now  look  for  fractures,  and  do  not  mistake  irregular  sutures 
for  these.  Notice  any  unusual  thinness  of  bone;  follow  out 
any  fracture  to  its  whole  extent ;  observe  any  extravasation 
of  blood  under  the  scalp. 

The  skull  should  now  be  carefully  sawed  around,  about 
half  an  inch  above  the  opening  of  the  ear,  the  calvarium 
removed,  and  the  condition  of  the  dura  mater  noticed.  This 
membrane  should  be  carefully  cut  around  with  a  probe- 
pointed  scissors,  and  the  arachnoid  and  pia  mater  closely 
inspected 

The  upper  part  of  the  brain  can  now  be  examined  before 
removal — as  to  congestion  of  its  vessels,  laceration,  or 
extravasation  of  blood  upon  its  surface.  (Remember  this 
latter  is  often  seen  on  the  side  opposite  to  the  external 
injury.)  The  brain  is  now  to  be  carefully  removed,  by 
inserting  the  fingers  beneath  it,  and  dividing  the  medulla 
oblongata. 

The  base  of  the  skull  should  be  carefully  inspected  for 
fractures,  which  otherwise  might  escape  notice. 

The  brain  should  now  be  examined  from  above,  slicing 
it  horizontally;  regarding  specially  its  consistence,  color, 
presence  of  extravasated  blood  or  serum,  of  tumors  or 
abscesses,  disease  of  blood  vessels,  or  of  the  membranes. 


60  MEDICAL   JURISPRUDENCE. 

In  opening  the  skull  of  very  young  children,  a  pair  of  strong 
scissors  may  be  used  instead  of  a  saw. 

(2)  The  Spinal  Column  should  be  opened  through  its 
whole  extent,  by  sawing  through  on  each  side  of  the  spinous 
processes.  The  cord,  together  with  the  dura  mater,  should 
then  be  removed  and  examined.  The  presence  of  fracture, 
dislocation,  or  contusion,  should  be  carefully  noticed. 

(3)  The  Neck  should  be  carefully  inspected  for  marks  of 
violence  by  the  fingers  (garrotting) ;  by  a  cord  (strangling 
or  hanging) ;  ecchymoses  ;  the  great  vessels,  whether  full  or 
empty;  the  nerves,  whether  in  their  natural  state.  The 
cavity  of  the  mouth  and  nose.  The  condition  of  the  larynx, 
trachea,  pharynx  and  oesophagus. 

The  thorax  and  abdomen  may  be  opened  together,  by  a 
single  incision,  extending  from  the  root  of  the  neck  to  the 
pubes,  and  a  transverse  one  across  the  umbilicus.  The 
thorax  should  be  first  examined,  except  in  the  bodies  of 
new-born  children,  where  it  is  important  to  observe  the  con- 
dition of  the  diaphragm ;  in  this  case  the  abdomen  should 
first  be  opened.  Moreover,  in  cases  of  death  from  asphyxia, 
it  is  recommended  by  Dr.  Tidy  to  examine  the  condition  of 
the  heart  before  opening  the  head,  because  the  blood  is  apt 
to  escape  from  the  right  side  of  the  heart  if  the  head  is 
opened  first. 

(4)  The  Thorax. — The  cartilages  of  the  ribs,  together  with 
the  sterno-clavicular  ligaments,  should  be  carefully  divided, 
avoiding  wounding  the  large  veins  of  the  neck,  and  the 
sternum  should  be  reflected.  Notice  the  condition  of  the 
lungs,  whether  adherent,  collapsed,  or  emphysematous. 
Record  immediately  the  position  and  color  of  the  thoracic 
viscera ;  also  the  presence,  and  amount,  and  nature  of  any 
fluid  in  the  pleural  cavity.  Open  the  pericardium,  and  note 
the  presence  and  amount  of  any  contained  fluid. 


INTERNAL    EXAMINATION    OF    THE    BODY.  (jl 

The  lungs  are  removed  by  passing  the  hand  beneath  them 
(noticing  any  adhesions),  and  cutting  through  the  bronchi 
and  vessels  at  their  roots.  They  should  be  inspected  as  to 
their  color,  density,  etc.,  as  indicating  disease  ;  the  condition 
of  the  bronchial  tubes  and  pulmonary  artery  (embolism); 
and  the  presence  of  foreign  matters  in  the  air  passages  (in 
case  of  drowning).  If  blood  has  escaped  into  the  thorax,  it 
should  be  removed  by  a  sponge,  so  as  to  ascertain  the  color 
of  the  parts.  The  hydrostatic  examination  of  the  lungs  in 
new-born  children  will  be  considered  farther  on. 

The  Heart  should  be  examined  in  situ,  before  removal, 
as  to  its  size,  and  the  fullness  of  the  coronary  vessels ;  the 
cavities  should  now  also  be  opened,  and  the  amount  of  their 
contained  blood  noted,  together  with  any  clots  or  polypi. 
The  organ  may  next  be  removed  by  cutting  through  the 
vessels  at  its  base,  and  examined  as  to  its  weight,  condition 
of  its  walls  and  tissue,  and  state  of  its  valves.  Sometimes 
a  microscopic  investigation  may  be  required.  The  aorta 
should  likewise  be  examined,  for  atheroma  and  aneurism. 

(5)  The  Abdomen. — On  removing  the  integuments,  the 
examiner  should  carefully  note  all  signs  of  peritonitis,  and 
of  swelling,  extravasation,  strangulation,  or  twist  of  the 
intestines,  and  hernia ;  likewise  the  condition  of  the  liver, 
spleen,  kidneys,  bladder ;  and,  in  the  female,  the  state  of  the 
vagina,  uterus  and  ovaries,  the  uterus  especially,  for  evidences 
of  pregnancy,  abortion,  and  delivery. 

The  Stomach  should  be  examined  by  first  ligating  it  at 
the  cardiac  extremity,  and  then  by  applying  two  ligatures  at 
the  pyloric  end,  and  cutting  between  them.  Note  the  general 
external  appearance,  and  then  open  it  along  its  lesser  curva- 
ture. Examine  the  contents,  as  to  quantity,  character  and 
odor,  and  reaction.  Carefully  inspect  the  lining  membrane 
with  a  lens,  for  solid  particles  of  phosphorus,  crystals,  or 


62  MEDICAL   JURISPRUDENCE. 

patches  of  arsenic,  or  other  mineral  poisons,  fragments  of 
leaves  or  seeds,  or  other  foreign  matters.  Note  any  evidences 
of  inflammation,  or  ulceration. 

The  Intestines  should  next  be  examined,  by  removing  them 
from  their  attachments,  and  slitting  them  throughout  with 
an  enterotome  ;  looking  for  inflammation  and  ulceration  of 
the  glands,  and  for  any  foreign  matters ;  also  noting  the 
condition  of  the  appendix  vermiformis.  In  cases  of  poison- 
ing, the  stomach  and  its  contents  should  be  preserved  for 
chemical  examination,  in  a  separate  jar.  The  intestines  also 
(at  least  a  portion  of  the  small  and  large  bowel,  together 
with  the  rectum),  and  portions  of  the  liver,  kidney  and 
spleen,  should  be  kept  for  a  similar  purpose.  The  jars  con- 
taining the  viscera  should  be  securely  stoppered,  and  sealed 
with  the  private  seal  of  the  examiner,  with  a  label  affixed, 
stating  the  name  of  the  deceased  person,  the  date  of  death 
and  of  the  autopsy.  They  should  then  be  delivered  per- 
sonally, by  him,  to  a  responsible  party,  from  whom  he 
should  always  take  a  written  receipt. 

In  case  of  disinterment  of  a  body,  the  inspectors  should 
always  view  it  before  it  is  removed  from  the  coffin;  at  which 
time,  also,  it  should  be  properly  identified  by  the  friends  or 
relatives  of  the  deceased. 

In  a  medico-legal  examination  of  a  body,  such  as  above 
described,  there  should  always  be  present  either  a  second 
inspector,  or  a  clerk,  to  take  down  the  notes  as  the  autopsy 
progresses.  These  notes  should  comprise  the  appearances 
presented  by  the  different  organs,  stating  only  facts,  but  no 
opinions.  The  notes  should  be  carefully  read  over  by  both 
examiners  before  sewing  up  the  body,  and,  if  necessary, 
corrected.  A  report  should  then  be  carefully  drawn  up, 
containing  the  opinion  of  the  case,  as  deduced  from  the 
ascertained  facts,  with  the  reasons  therefor,  clearly  and 
succinctly  stated,  but  avoiding  all  theorizing  on  the  subject. 


PRESUMPTION    OF    DEATH.  63 


CHAPTER    IV. 

PRESUMPTION  OF  DEATH,  AND  OF  SURVIVORSHIP. 

CASES  INVOLVING  PRESUMPTION  OF  DEATH,  AND  OF  SURVIVORSHIP. 
— FRENCH  LAW  OF  SURVIVORSHIP. — PROBABILITIES  AFFORDED  BY 
AGE,   SEX,    AND   MODE   OF    DEATH. 

Presumption  of  Death. — This  question  may  be  raised  when 
a  person  goes  away -from  home,  and  is  not  heard  of  for  many 
continuous  years.  The  law  will,  in  that  event,  regard  him 
as  dead,  or  presume  his  death,  and  his  administrator  or 
executor  may  proceed  to  settle  his  estate.  The  question 
under  this  form  is  not  unfrequently  raised  in  life  insurance 
companies,  where  the  party  insured  has  not  been  heard  of 
for  many  years,  and  his  lawful  heirs  demand  the  payment 
of  his  policy.  It  must  also  be  considered  in  cases  where 
a  husband  deserts  his  wife,  or  vice  versa;  or  where  either 
married  person  leaves  the  other,  and  remains  continuously 
away;  or  where  the  party  going  away  without  the  inten- 
tion of  remaining,  is  not  afterwards  heard  of  for  a  succession 
of  years. 

The  length  of  time  usually  regarded  as  legally  warranting 
a  presumption  of  death,  in  any  of  the  above  cases,  is  seven 
years  from  the  time  the  person  was  last  heard  from;  so  that 
in  the  case  of  married  persons,  it  is  not  regarded  as  bigamy 
if  the  other  party  should  marry  again  after  the  expiration 
of  the  seven  years  of  continuous  absence,  without  being 
heard  from,  or  being  known  to  be  alive.  In  cases  of  heir- 
ship and  property,  and  in  some  cases  of  life  insurance,  it  is 
often  not  considered  necessary  to  wait  the  whole  seven  years, 
but  a  settlement  has  been  made  by  the  courts  or  company 
in  two  years. 


64  MEDICAL   JURISPRUDENCE. 

The  presumption  of  death  must  depend  on  general 
evidence,  being  a  presumption  of  fact  to  be  determined  by 
a  jury.  There  are  cases,  however,  of  a  special  character, 
where  the  courts  have  decided  the  presumption  of  death  to 
be  sooner  or  later  than  the  period  of  seven  years,  as,  e.  g.t  if 
the  individual  concerned  was  in  feeble  health  when  he,  or 
she,  was  last  heard  from.  This  question  would  involve 
medical  evidence  as  to  the  probabilities  of  life,  in  such  a 
case. 

Presumption  of  Survivorship. — Questions  relating  to  pre- 
sumption of  survivorship  are  much  more  frequently  discussed 
in  the  courts  than  those  pertaining  to  presumption  of  death. 
There  is,  however,  no  general  law  upon  the  subject,  either 
in  this  country,  or  Great  Britain,  every  case  in  which  the 
question  is  involved  being  decided  according  to  its  indi- 
vidual merits.  When  two  or  more  persons  perish  by  the 
same  calamity,  in  the  absence  of  all  testimony,  the  courts 
frequently  refuse  to  assume  that  one  survived  the  others, 
but  have  decided  that  all  perished  together.  Yet,  very 
momentous  questions  may  be  dependent  upon  a  legal  deci- 
sion of  the  question  of  survivorship;  as  when  the  parties 
dying  are  a  father  and  a  son ;  if  the  son  survive  but  for  a 
moment, "  his  wife  shall  have  dower,  for  the  lands  descended 
the  instant  the  father  died."  So,  in  the  case  of  a  testator 
and  legatee ;  if  the  latter  dies  first,  the  legacy  lapses  ;  but  if  he 
survives  the  testator,  for  ever  so  short  a  time,  his  executors 
can  claim.  So,  again,  the  husband  of  a  woman  possessed 
of  freehold  property  (not  specially  settled),  has  a  life  int< 
in  her  estate,  provided  she  has  issue  by  him,  born  during 
the  life  of  the  mother,  and  which  survives  her  even  for  a 
moment  of  time  {tenancy  by  courtesy).  The  old  Roman 
law  upon  this  subject,  upon  which  are  based  most  of  our 


PRESUMPTION    OF   SURVIVORSHIP.  65 

modern  decisions,  enacted  that  when  persons  of  different 
ages  perished  in  battle,  those  under  puberty  were  deemed 
to  have  died  first ;  but  if  the  son  was  above  the  age  of 
puberty,  and  both  died  together,  the  son  was  presumed  to 
have  survived  the  parent.  In  the  case  of  husband  and  wife, 
the  husband  was  presumed  to  be  the  survivor  (Beck). 

According  to  Fodere  and  Beck,  the  French  law,  as  con- 
tained in  the  Code  Napoleon,  is  as  follows : 

"  I.  If  several  persons,  naturally  heirs  of  each  other,  perish 
by  the  same  event,  without  the  possibility  of  knowing  which 
died  first,  the  presumption  as  to  survivorship  shall  be  deter- 
mined by  the  circumstances  of  the  case;  and  in  default 
thereof,  by  strength  of  age  and  sex. 

"II.  If  those  who  perished  together  were  under  fifteen 
years,  the  oldest  shall  be  presumed  the  survivor. 

"  III.  If  they  were  all  above  sixty  years  of  age,  then  the 
youngest  shall  be  presumed  the  survivor. 

"IV.  If  some  were  under  fifteen,  and  others  above  sixty, 
the  former  shall  be  presumed  the  survivors. 

"V.  If  those  who  perished  together  were  over  the  age  of 
fifteen,  but  under  sixty,  the  males  shall  be  presumed  the 
survivors,  where  the  ages  are  equal,  or  the  difference  does 
not  exceed  one  year. 

"VI.  If  they  were  of  the  same  sex,  that  presumption  shall 
be  admitted  which  opens  the  succession  in  the  order  of 
nature.  Of  course,  the  younger  shall  be  considered  to  have 
survived  the  elder." 

According  to  Section  IV  in  the  above  Code,  no  distinc- 
tion is  made  between  an  infant  and  a  man  of  sixty  years ; 
yet  certainly,  it  may  fairly  be  supposed  (as  remarked  by  Dr. 
Tidy)  that  the  latter  had  a  better  chance  of  life  than  the 
former.  The  Prussian  law  on  this  question  is  about  iden- 
tical with  the  Code  Napoleon. 
4* 


GQ  MEDICAL  JURISPRUDENCE. 

Although  our  laws  are  not  decisive  on  questions  of  pre- 
sumption of  survivorship,  but  treat  them  as  questions  of 
fact  depending  wholly  on  evidence,  and,  in  the  absence  of 
all  evidence,  regarding  them  as  matters  incapable  of  being 
determined,  still,  there  are  certain  matters  of  importance 
connected  with  each  case  as  it  presents  itself,  which  deserve 
the  consideration  of  the  court  and  jury,  in  influencing  their 
decision.  These  points  may  be  considered  under  the  follow- 
ing heads : 

(i)  Probabilities  afforded  by  the  Age. — Between  a  father, 
and  a  child  under  puberty,  the  English  civil  law  decides  the 
father  to  be  the  survivor.  Between  the  ages  of  fifteen  and 
sixty,  there  is  no  probability.  Between  a  middle-aged  man, 
and  one  under  fifteen  and  over  sixty,  the  probabilities  are  in 
favor  of  the  former.  Between  one  under  fifteen  and  one 
over  sixty,  the  former  is  deemed  the  survivor;  but  the  same 
exception  might  be  taken  here  as  in  the  case  of  Sect.  IV  of 
the  Code  Napoleon  (supra).  Between  two  under  fifteen,  the 
oldest  is  considered  the  survivor.  If  the  question  is  between 
a  mother  and  infant,  both  dying  in  childbed,  without  assist- 
ance, the  presumption  of  survivorship  is  in  favor  of  the 
mother,  because  the  child  might  be  still-born,  and  also 
because,  if  large,  its  life  might  be  endangered  by  delay,  and 
it  would  be  more  exposed  to  danger  without  assistance, 
such  as  strangulation  by  the  cord,  or  suffocation  in  the 
discharges  of  the  mother. 

(2)  Presumption  afforded  by  the  Sex. — The  presumption 
is  in  favor  of  the  male,  when  it  is  a  question  of  physical 
strength  and  courage,  as  when  a  man  and  woman  perish 
together  by  drowning,  or  some  other  casualty.  But  in  par- 
ticular cases,  the  question  of  the  respective  health  of  the 
two  persons  might  have  to  be  considered.  When,  however, 
it  is  a  question  of  passive  endurance,  especially  where  insen- 


PRESUMPTION    OF    SURVIVORSHIP.  07 

sibility  supervenes,  then  the  presumption  is  in  favor  of  the 
female. 

(3)  The  Cause  of  Death,  as  affording  a  presumption  of  sur- 
vivorship. In  death  from  asphyxia  (apncea),  as  in  smother- 
ing, or  breathing  noxious  gases,  as  women  require  less 
oxygen  than  men,  the  probabilities  are  in  favor  of  the 
former,  other  things  being  equal.  Thus,  it  is  stated  that,  in 
Paris,  in  one  year,  there  occurred  three  hundred  and  sixty 
cases  of  poisoning  by  charcoal  vapors  ;  of  this  number  there 
were  nineteen  instances  where  a  man  and  a  woman  were 
exposed  together,  and  of  these  only  three  survived,  and  all 
were  females.  Dr.  Beck  relates  the  case  of  a  man,  wife  and 
child,  who  were  all  asphyxiated  while  sleeping  in  a  room 
which  was  exposed  to  the  vapors  of  a  coal  stove.  In  the 
morning,  the  man  was  found  dead,  the  child  dying,  but  the 
woman  recovered. 

In  drowning,  or  shipwreck,  the  question  becomes  very 
complicated,  having  to  take  into  the  account  age,  sex, 
strength  and  opportunity.  Thus,  men,  being  stronger,  more 
likely  to  be  able  to  swim,  and,  in  case  of  shipwreck,  being 
more  apt  to  be  on  deck,  and,  therefore,  in  a  better  position 
to  escape,  have  the  best  probabilities  for  survival ;  but,  on 
the  other  hand,  the  buoyancy  of  a  woman's  clothes  might 
support  her  in  the  water,  and  thus  save  her  life,  under  pos- 
sible circumstances.  In  case  of  two  or  more  persons,  all 
males,  equally  exposed,  a  presumption  of  survivorship  can 
only  be  entertained  by  searching  for  bodily  injuries,  or 
other  weakening  causes,  which  would  necessarily  interfere 
with  the  individual's  exertions  to  save  his  life.  Here,  also, 
their  respective  swimming  capacities  would  have  to  be  con- 
sidered. 

If  the  question  be  on  the  survivorship,  in  the  case  of 
several  persons   exposed  to  excessive  cold,  the   amount  of 


(J8  MEDICAL    JURISPRUDENCE. 

clothing,  the  physical  condition,  and  the  immoderate  use 
of  alcohol,  must  all  be  considered  before  arriving  at  a  con- 
clusion. The  probabilities  would  here  be  in  favor  of  the 
strong  adult  over  the  very  young,  or  very  old  person,  and 
of  males  over  females.  The  debilitating  effects  of  poverty, 
entailing  a  bad  nutrition,  and  also  of  intoxication,  as  being 
especially  obnoxious  to  the  effects  of  cold,  should  not  be 
overlooked.  The  perishing  of  drunken  people  on  a  cold 
winter's  night  is  a  too  familiar  occurrence.  In  relation  to 
the  effects  of 'heat,  it  maybe  remarked  that,  while  the  young 
and  old  suffer  more  from  cold  than  adults,  they  seem  able 
to  withstand  a  greater  amount  of  heat  than  the  latter. 

In  death  by  starvation,  the  general  principle  that  the 
young  require  more  food  than  the  aged,  will  determine  the 
presumption  of  survivorship  to  be  in  favor  of  the  latter ; 
also  for  the  female,  rather  than  the  male.  Certain  circum- 
stances, however,  should  here  be  considered,  such  as  prox- 
imity to  water,  which  would  aid  in  sustaining  life  for  some 
time,  even  without  food. 


PERSONAL    IDENTITY.  69 


CHAPTER   V. 

PERSONAL  IDENTITY. 
SECTION  I. 

IMPORTANT    MEDICO-LEGAL    BEARINGS. — I.    IDENTIFICATION   OF   THE 

LIVING. — PERSONAL    APPEARANCE. —  PECULIAR     BODILY      MARKS. — 
REMARKABLE   CASES. 

The  medico-legal  consideration  of  the  subject  of  personal 
identity  is  much  more  important  than  it  may  appear  at  first 
sight.  The  question  is  often  raised  in  trials,  both  of  a  civil 
and  criminal  character,  and  it  may  constitute  the  chief  link 
in  the  whole  chain  of  evidence.  Cases  of  mistaken  identity 
are  constantly  occurring,  and  proofs  abundant  might  be 
adduced  to  show  that  innocent  persons  have  frequently 
been  made  to  suffer  the  penalty  of  death  judicially,  instead 
of  the  guilty,  simply  through  an  error  of  this  nature.  Should 
an  alleged  child,  or  other  claimant  present  his  claim  to  an 
inheritance,  he  must  first  establish  his  identity  before  taking 
further  steps  in  the  suit.  Is  an  individual  assaulted,  or 
robbed?  he  will  be  required  to  identify  his  assailant  before 
he  can  successfully  prosecute  him.  Or,  again,  a  person, 
after  many  years'  absence  in  foreign  climes,  returns  home  to 
claim  his  rightful  property  or  title,  but  he  is  so  changed  as 
to  be  unrecognized  by  his  nearest  relatives  ;  he  must  be  able 
to  prove  his  identity  before  the  courts,  before  his  claim  can 
be  sustained.  And  then,  in  relation  to  persons  found  dead — 
whether  in  cases  of  recent  death,  where  the  body  has  under- 
gone but  little  change,  or  years  after  the  decease,  where 
nothing  remains  of  the  body  from  which  to  glean  the  im- 
portant information  but  the  bare  skeleton — the  question  of 


70  MEDICAL   JURISPRUDENCE. 

personal  identity  acquires  the  most  intense  interest,  more 
especially  in  a  trial  for  murder,  where  it  becomes  essential 
to  establish  the  identity  of  the  alleged  victim  as  the  corpus 
delicti. 

It  is  true  that  the  aid  of  the  physician  is  not  so  frequently 
invoked  for  proving  the  identity  of  the  living \  since  this 
can  generally  be  established  as  satisfactorily  by  friends  and 
neighbors,  *as  by  medical  men.  Still,  there  may  be  occa- 
sions of  unusual  complexity,  in  which  a  professional  opinion 
may  become  requisite,  as,  for  example,  to  verify  certain 
deformities,  fractures,  scars,  and  other  marks  about  the 
person,  when  these  constitute  the  evidences  on  which  the 
identification  may  be  dependent. 

The  subject  will  be  considered  under  the  two  divisions  of  ( i) 
The  Identity  of  the  Living,  and  (2)  The  Identity  of  the  Dead. 

I.  The  Identity  of  the  Living. — This  may  usually  be  es- 
tablished by  the  direct  evidence  of  witnesses  who  have 
known  the  individual  sufficiently  long  to  have  a  distinct 
recollection  of  his  personal  appearance;  such  is  the  testi- 
mony of  relatives,  friends  and  acquaintances.  Although 
among  the  myriads  of  the  human  family  it  is  very  rare  to 
find  two  persons  exactly  alike  in  all  points,  yet  remarkable 
instances  do  occasionally  occur  where  the  personal  resem- 
blance is  so  striking  as  to  baffle  even  the  skill  of  the  detect- 
ive; and  this  resemblance  has  been  made  still  stronger  by 
the  existence  of  similar  marks,  cicatrices,  or  certain  peculi- 
arities of  structure,  in  both  individuals.  Some  striking  illus- 
trations might  be  given  of  the  extreme  difficulty — amounting, 
at  times,  to  an  impossibility — of  deciding  the  question,  which 
also  go  to  show  how  easily  witnesses  may  be  mistaken  in 
their  evidence  on  this  subject.  Only  two  will  be  here  re- 
ferred to. 


IDENTITY    OF    THE    LIVING.  71 

In  the  year  1560  the  celebrated  case  of  Martin  Guerre 
and  Armand  du  Tilh  was  tried  before  the  Parliament  of 
Toulouse.  Martin  had  been  absent  from  his  home  for  eight 
years,  when  the  person  named  du  Tilh  appeared,  and 
represented  himself  as  the  long  absent  man.  So  strong 
was  the  resemblance,  that  his  statement  was  universally 
accepted  by  all  of  Guerre's  family,  including  his  wife,  four 
sisters  and  two  brothers-in-law,  among  whom  he  lived 
unsuspected  for  three  years.  About  this  time,  however, 
something  occurred  to  excite  suspicions  as  to  the  true 
character  of  the  supposed  husband  and  brother,  when  he 
was  arrested,  and  brought  before  the  tribunal,  on  a  charge  of 
fraud.  Upon  his  examination  he  gave  satisfactory  answers 
to  the  most  minute  questions  in  relation  to  Guerre's  former 
life.  Some  one  hundred  and  fifty  witnesses  were  examined 
during  the  investigation,  of  whom  between  thirty  and  forty 
testified,  from  a  life-long  acquaintance,  that  the  prisoner  was 
Martin  Guerre ;  while  about  the  same  number  swore  posi- 
tively that  he  was  Armand  du  Tilh,  whom  they  well  knew; 
and  over  sixty,  who  knew  them  both,  declared  that  they 
were  unable  to  say  which  the  prisoner  was.  Finally,  how- 
ever, the  real  Martin  appeared  upon  the  scene,  when  imme- 
diately he  was  recognized.  The  four  sisters  who  had 
previously  testified  that  du  Tilh  was  their  real  brother,  now 
admitted  their  error,  and  acknowledged  the  distinction. 
There  being  now  no  doubt  of  the  guilt  of  the  prisoner,  he 
was  condemned,  and  afterwards  executed.  (Wharton  and 
Stille's  Med.  Jurisp.  Vol.  II,  p.  1092.) 

The  other  instance  is  afforded  in  the  recent  famous 
Tichborne  case,  in  which  a  person  named  Orton,  with 
various  aliases,  undertook  to  personate  an  English  baronet, 
heir  to  a  large  entailed  estate.  So  successful  was  his  scheme 
that  "  he  was  sworn  to  be  Sir  Roger  Tichborne  by  eighty- 


VI  MEDICAL   JURISPRUDENCE. 

five  witnesses,  among  whom  were  Sir  Roger's  mother,  the 
family  solicitor,  one  baronet,  six  magistrates,  one  general, 
three  colonels,  one  major,  two  captains,  thirty-two  non- 
commissioned officers  and  privates  of  the  army,  four  clergy- 
men, seven  tenants  of  the  Tichborne  estates,  and  seventeen 
servants  of  the  family."  The  claimant  also  gave  proof  of 
"  a  fish-hook  wound  on  the  eye,  of  a  mark  of  bleeding  on 
the  ankle,  and  of  a  peculiar  scar  on  the  head,"  all  of  which 
the  genuine  Sir  Roger  possessed.  The  case,  however,  broke 
down  on  cross-examination,  many  circumstances  being 
proven  against  the  claimant,  which  need  not  be  here 
enumerated.  Suffice  it  to  say  that  a  verdict  was  taken 
against  him,  and  that  an  indictment  was  since  found  against 
him  for  perjury. 

Now,  as  a  fair  inference  from  the  above  two  instances, 
and  other  remarkable  cases,  we  may  assume,  that  appear- 
ances are  not  conclusive  evidences  of  personal  identity  ;  and, 
as  a  sufficient  reason  for  this  we  must  admit  the  fact  that 
"  a  large  proportion  of  ordinary  persons  are  very  untrust- 
worthy witnesses  to  identity,  when  dependent  on  appear- 
ances alone.  They  are,  from  nature  or  habit,  incapable  of 
appreciating  form,  and  form  alone  is  the  unerring  proof  of 
personal  identity.  The  difficulties  in  the  way  of  identifica- 
tion, more  especially  of  the  dead,  are  to  them  insuperable  " 
{Loud.  Spectator).  To  this  inherent  difficulty  on  the  part 
of  the  witnesses,  may  be  added,  their  want  of  previous 
training  as  minute  observers ;  and  also,  the  well-known 
fact  of  the  adroitness  of  criminals  at  personal  disguisement. 

A  second  means  of  establishing  the  identity  of  the  living, 
especially  in  a  criminal,  is  by  certain  peculiarities  in  the 
appearance,  which  are  noticed  at  the  time  of  the  commission 
of  the  crime,  and  which  are,  therefore,  apt  to  leave  a  strong 
impression  on  the  senses, — such   as  (a)  size,  when  the  indi- 


IDENTITY    OF   THE    LIVING.  73 

vidual  is  very  tall  or  very  short,  very  corpulent  or  very 
slim;  whether  lame,  or  otherwise  deformed;  (//)  dress, 
when  a  portion — sometimes  a  mere  shred — of  the  prisoner's 
dress  is  discovered  near  the  seat  of  the  crime,  which  ex- 
actly corresponds  with  the  rest  of  the  garment  found  on 
his  person,  or  in  his  own  house. 

A  third  means  of  identification  is  afforded  by  the  voice. 
Peculiarity  of  the  voice  (such  as  depth  or  shrillness,  lisping 
or  stammering)  always  makes  a  strong  impression  upon 
those  who  hear  it,  and  constitutes  a  valuable  aid  in  personal 
identification. 

Fourthly,  the  presence  of  certain  peculiar  marks,  either 
natural  or  acquired,  about  the  person,  often  affords  material 
aid  in  establishing  identity.  These  marks  comprise  moles, 
nsevi,  scars,  cicatrices,  deformities,  fractures,  tattoo-marks, 
etc.  Such  marks  are  usually  well  known,  and  remembered 
by  relatives  and  friends  of  the  individual,  who  can  usually 
identify  them.  Some  of  these  remain  upon  the  body 
during  life;  others  gradually  decline  and  fade  away.  In 
relation  to  tattoo-marks,  Prof.  Casper's  experience  leads  to 
the  inference  that  some  of  them  (the  red  ones)  are  gradually 
obliterated  by  time,  while  the  black  and  purple  ones  are 
more  permanent.  A  cicatrix  is  permanent  during  life,  if 
there  has  been  any  original  loss  of  substance.  It  may  not 
always  be  distinguished  from  the  surrounding  skin,  unless 
the  part  be  smartly  rubbed,  when  the  white  scar  is  immedi- 
ately manifested  on  the  red  surrounding  surface.  Caution 
should  be  given  against  too  strong  a  reliance  upon  scars  as 
a  means  of  identity,  since  these  may,  at  times,  be  dis- 
covered upon  another,  precisely  similar,  both  as  to  form 
and  situation. 

Under  this   head   may  be  mentioned  the  appearance   of 
the  hands  (whether  hard  and  horny,  or  soft  and  pliant,  or 


7  1  MEDICAL   JURISPRUDENCE. 

whether  stained  in  a  peculiar  manner),  as  often  indicating 
the  nature  of  the  occupation  of  the  individual. 

Photographs  and  other  portraits  of  the  suspected  person 
are  sometimes  useful  aids  in  the  identification  of  the  living, 
as  well  as  of  the  dead;  but  caution  is  requisite  here,  since 
the  art  of  the  photographer  in  the  touching  up  of  the  picture 
frequently  makes  it  an  unfaithful  representative  of  the  nega- 
tive. 

As  bearing  upon  this  subject,  it  may  be  proper  to  say  a 
few  words  upon  vision  and  hearing.  The  following  remarks 
are  abridged  from  Woodman  and  Tidy's  Forensic  Medicine. 
The  limits  of  normal  vision  or  healthy  sight,  unassisted  by 
instruments,  in  a  perfectly  clear  atmosphere,  are  as  follows : 

At  a  height  of        5  feet,  the  range  of  distance  is  2.96  miles. 

"  20     "  "  "  5.91      " 

50     "  «  "  9.35      " 

"         «          100     "  "  "  13.2        " 

"  u  500      «  u  u  29#5 

"  "  IOOO      -  "  "  4I.8  " 

"  "         5OOO      "  "  "  94  " 

It  follows  from  this,  that  a  man  of  ordinary  height  may  be 
seen  on  level  ground  at  a  distance  of  two  or  three  miles,  on 
a  clear  day;  but  this  is  very  different  from  recognition  of  the 
person,  so  as  to  identify  him.  The  effects  of  age  upon  the 
acuteness  of  vision  is  considered  by  Dr.  De  Gueret  to  be  as 
follows : — 

At  fifty  years  it  is  diminished  one-fifth ;  at  sixty  years 
one-fourth ;  at  seventy  years,  one-third ;  at  eighty  years, 
one-half.  In  other  words,  if  a  man  of  thirty  or  forty  could 
distinguish  an  object  at  one  hundred  feet  distance,  at  sixty 
years  of  age  he  could  not  recognize  it  further  off  than 
seventy-five  feet,  or,  at  eighty  years,  at  fifty  feet. 

The  recognition  of  persons  at  a  nearer  or  greater  distance, 
is  afforded  by  their  stature,  gait,  complexion,  color  of  the  hair 


IDENTIFICATION    BY   SIGHT    AND   SOUND.  /  -> 

and  eyes,  and  peculiarities  of  appearance.  According  to  the 
above  authority,  the  best-known  persons  can  be  recognized 
often  with  difficulty,  in  broad  daylight,  at  one  hundred 
metres,  or  about  one  hundred  and  nine  yards.  Less  known 
persons  may  be  recognized,  in  broad  daylight,  at  sixty  to 
one  hundred  yards ;  and  people  who  are  almost  strangers, 
and  who  have  no  personal  peculiarities,  at  twenty-seven  to 
thirty-three  yards.  By  the  clearest  moonlight,  the  best- 
known  persons  cannot  be  recognized  further  off  than  six- 
teen or  seventeen  yards.  By  starlight,  recognition  cannot 
be  effected  beyond  ten  to  thirteen  feet.  The  light  of  &  flash 
of  lightning  enabled  a  lady,  on  her  passage  home  from  India, 
to  see  distinctly  the  features  of  a  man  who  was  robbing  her 
trunk  in  the  cabin  of  a  vessel,  on  a  very  dark  night;  and 
authentic  instances  are  given  where,  by  the  flash  of  a  pistol 
or  gun,  sufficient  light  was  momentarily  afforded  to  enable 
not  only  an  assailant  to  be  recognized,  but  likewise  the 
color  and  appearance  of  his  horse  The  subjective  sensa- 
tion of  flashes  of  light  or  sparks,  produced  by  a  blow  upon 
the  eyeball,  has  no  effect  whatever  in  aiding  recognition  ; 
since  the  same  sensation  is  often  experienced  by  those  who 
are  totally  blind. 

The  distance  at  which  sounds  (such  as  the  report  of  a 
gun  or  pistol)  continue  to  be  audible  cannot  be  determined 
with  accuracy,  since  it  depends  upon  the  direction  of  the 
wind,  the  condition  of  the  atmosphere  as  to  moisture,  and 
other  disturbing  sounds.  The  velocity  of  sound  may  be 
stated  to  be,  on  an  average,  1 1 35  feet  per  second,  which  is 
about   13  miles  a  minute,  or  one  mile  in  about  4J/  seconds. 


76  MEDICAL   JURISPRUDENCE. 

SECTION  II. 

II.  IDENTIFICATION  OF  THE  DEAD. — MUTILATED  REMAINS. — IDENTI- 
FICATION BY  MEANS  OF  THE  SKELETON,  AS  TO  AGE,  SEX  AND 
STATURE. — RULES  OF  PROPORTION. — FRACTURES,  DEFORMITIES  AND 
CALLUS. — AGE  OF  BONES. — EXAMINATION  OF  HAIR  AND  FIBRES. 

The  Identification  of  the  Dead. — This  may  have  reference 
(i)  to  the  body  recently  dead;  and  (2)  when  the  soft  parts 
have  disappeared  by  putrefaction,  and  the  skeleton  only 
remains,  or  where  detached  bones  merely  have  been  dis- 
covered. 

When  the  death  has  but  recently  occurred,  and  the  body 
is  unmutilated,  most  of  the  same  general  methods  of  estab- 
lishing identity  are  available  as  have  already  been  mentioned 
in  the  case  of  the  living, — such  as  the  testimony  of  relatives 
and  acquaintances  as  to  the  personal  appearance  of  the 
deceased,  certain  marks  upon  the  person,  as  na^vi,  moles, 
cicatrices,  tattoo-marks,  fractures,  deformities,  etc.  Photo- 
graphs and  other  portraits  are  here  also  admissible,  although 
by  no  means  reliable  proofs. 

If  the  body  has  been  subjected  to  mutilation  after  death, 
and  the  severed  portions  removed  to  a  distance  from  one 
another,  and  some  of  them  even  destroyed,  as  is  sometimes 
done  by  a  murderer  with  a  view  to  escape  detection,  the 
difficulty*  of  identification  is,  of  course,  very  much  increased. 
Nevertheless,  if  the  disconnected  parts  can  be  recovered,  or 
even  a  portion  of  them,  it  will  always  be  possible  for  a 
skilled  anatomist  so  to  readjust  them,  as  to  build  up  again 
the  bod}-,  so  to  speak,  by  making  the  proper  allowance  for 
the  missing  parts,  and  comparing  these  with  other  average 
specimens  of  a  similar  kind.  Several  striking  examples  of 
this  character  are  given  in  the  books.  One  of  these  is  the 
well-known  case  of  Dr.  Parkman,  who  was  murdered  by 
Dr.   Webster,   in    Boston,    Mass.,  about   thirty   years   ago. 


IDENTIFICATION    OF    MUTILATED    REMAINS.  77 

After  the  death  of  his  victim,  Dr.  Webster  attempted  to 
destroy  all  evidences  of  the  deed  by  cutting  up  the  body 
into  fragments,  some  of  which  were  burned  in  a  grate,  some 
immersed  in  chemicals  and  others  packed  away  in  boxes  in 
distant  parts  of  the  building.  On  the  discovery  of  these 
remains,  a  week  after  the  murder,  the  portions  of  the  body 
were  accurately  examined  by  a  skilled  anatomist.  It  was 
proved  that  they  were  human  remains,  belonging  to  one 
and  the  same  body ;  of  the  male  sex  ;  and  that  they  had  not 
been  dissected  for  anatomical  purposes,  but  cut  and  hacked 
in  different  directions,  for  the  object,  evidently,  of  mutilation. 
On  restoring  these  disjointed  parts  in  situ,  and  supplying 
the  deficient  portions,  it  was  found  that  the  proper  measure- 
ments agreed  closely  with  those  of  the  missing  Dr.  Park- 
man.  This  circumstance,  together  with  the  discovery  of 
certain  marks  of  identity  about  the  teeth  and  jaws  (the  head 
had  been  almost  completely  destroyed  by  fire),  afforded 
sufficient  evidence  of  the  personal  identity  of  the  missing 
gentleman  to  enable  the  jury,  on  the  trial  of  Dr.  Webster, 
to  find  a  verdict  of  guilty.  Another  instance  of  a  somewhat 
similar  nature  is  recorded  by  Professor  Taylor,  in  his  Medi- 
cal Jurisprudence.  A  number  of  years  ago  a  murder  was 
committed  in  London,  on  the  river  Thames,  and  shortly 
afterward  a  package  containing  mutilated  human  remains 
was  discovered  on  one  of  the  abutments  of  Waterloo  bridge. 
The  murderer  had,  no  doubt,  intended  to  throw  the  bundle 
into  the  river,  but  it  had  lodged  on  the  projection  in  its 
descent.  Dr.  Taylor  was  requested  to  examine  and  identify 
these  mutilated  remains ;  and  when,  after  great  difficulty, 
the  parts  were  brought  together  and  found  to  fit,  the  body 
was  identified  as  that  of  a  man  who  had  recently  disappeared 
from  a  vessel  on  the  river — a  Swedish  sailor. 

When  the   question  of  identity   relates   to   the   skeleton 


-  B  MEDICAL   JURISPRUDENCE. 

merely,  or  only  to  portions  thereof,  the  answer  cannot  be 
always  satisfactory,  and  the  medical  jurist  has  need  of  much 
caution  and  reserve  before  giving  a  positive  opinion. 

The  very  first  thing  for  him  to  determine  is,  whether  the 
bones  submitted  to  his  inspection  are  human  bones,  or  those 
of  some  of  the  inferior  animals.  Doubtless,  if  the  entire 
skeleton  be  discovered,  there  need  be  no  uncertainty  about 
the  matter ;  but  if  only  a  single  bone  or  two  be  found,  a 
mistake  may  easily  be  made,  except  by  a  practiced  anatomist 
and  osteologist.  Indeed,  many  ludicrous  blunders  are 
recorded,  of  persons  of  otherwise  good  medical  education 
mistaking  the  bones  of  the  ox,  horse,  dog,  pig  and  goat  for 
those  of  the  human  subject.  But  may  not  something  be 
learned  by  the  aid  of  chemistry,  or  the  microscope  ?  The 
reply  must  be,  generally,  in  the  negative.  Certainly  the 
bones  of  the  aged  do  contain  more  calcareous  matter  than 
those  of  the  young,  and  consequently  present  a  somewhat 
different  appearance  under  the  microscope.  But  human 
bones  have  the  same  general  chemical  composition  as  those 
of  the  lower  animals.  It  is  also  true  that  the  bone-cells  or 
corpuscles  vary  somewhat  in  size  in  the  different  orders  of 
animals,  being  largest  in  reptiles,  smallest  in  birds  and 
mammals,  and  intermediate  in  fishes.  In  this  respect  there 
is  an  analogy  with  the  size  of  the  blood-corpuscles  in  these 
different  orders.  But  these  are  only  generalizations,  and 
would  be  of  little  practical  use  in  individual  instances.  To 
be  sure,  the  microscope  will  enable  us  to  determine  the  fact 
of  any  specimen  submitted  being  bone,  or  not,  by  the  pre- 
sence or  absence  of  the  bone-cells  ;  but  it  can  go  no  further, 
inasmuch  as  it  cannot  distinguish  the  bone-cell  of  a  man 
from  that  of  a  mouse,  or  of  an  elephant. 

If  the  skull  is  the  only  portion  of  the  skeleton  submitted 
for  examination,  there  can  usually  be  no  difficulty  in  recog- 


DETERMINATION    OF    THE    AGE.  70 

nizing  it  as  human ;  the  only  doubt  that  might  arise  would 
be  the  possibility  of  its  belonging  to  one  of  the  higher  order 
of  (anthropoid)  apes ;  but  even  here,  there  are  important 
differences  which  would  not  be  overlooked  by  one  skilled 
in  comparative  anatomy  and  osteology.  The  further  ques- 
tion, whether  from  the  examination  of  a  skull  simply,  it  is 
possible  to  decide  to  what  race  the  individual  belonged — 
Caucasian  or  otherwise — we  do  not  think  can  be  answered 
with  absolute  certainty.  Doubtless,  well-marked  typical 
skulls  may  be  identified  as  belonging  to  some  particular 
race,  e.  g.,  the  negro,  or  Caucasian  ;  but  we  must  remember 
that  the  points  of  distinction,  which  in  well-marked  speci- 
mens serve  to  separate  these,  shade  away  in  many  instances, 
so  as  to  make  it  extremely  difficult,  if  not  impossible,  to 
give  a  medico-legal  opinion  in  an  isolated  case. 

Another  important  point  is  to  ascertain  whether  all  the 
bones  submitted  for  inspection  belong  to  one  and  the  same 
skeleton.  The  mere  fact  of  their  being  discovered  together 
does  by  no  means  necessarily  prove  it,  since  they  might 
have  been  so  placed  either  accidentally,  or  with  the  design 
of  eluding  detection  of  some  crime. 

In  the  identification  of  the  dead  by  means  of  the  skeleton, 
or  by  detached  bones,  the  three  leading  points  to  determine 
are  (i)  the  age,  (2)  the  sex,  and  (3)  the  stature. 

I.  The  Age. — This  can  generally,  in  young  subjects,  be 
pretty  accurately  determined  by  the  development  of  the 
teeth,  and  by  the  progress  of  ossification  in  the  different 
bones.  In  the  skeletons  of  new-born  children,  and  before 
the  teeth  have  appeared,  it  may  become  important  for  the 
medical  jurist  to  be  able  to  decide  upon  the  age,  in  order 
either  to  rebut  or  confirm  a  charge  of  infanticide.  It  is 
authoritatively  stated  that  in  the  jaws  of  a  child  at  full  term 


MEDICAL   JURISPRUDENCE. 

there  will  always  be  found  the  rudiments  of  twenty-four 
teeth — twenty  primary  teeth,  and  four  permanent  molars. 
Hence,  if  only  the  jaws  of  an  infant  be  discovered,  medical 
evidence  of  its  probable  age  may  be  given.  The  average 
date  of  the  eruption  (cutting)  of  the  teeth  is,  according  to 
Mr.  Bell,  as  follows  :  The  four  central  incisors  appear  from 
five  to  eight  months  after  birth ;  the  four  lateral  incisors, 
from  seven  to  ten  months;  the  four  anterior  molars,  from 
twelve  to  sixteen  months;  the  four  cuspidati,  irom  fourteen  to 
twenty  months;  and  the  four  posterior  molars  from  eighteen 
months  to  three  years.  Between  six  and  seven  years  the 
jaws  contain  forty-eight  teeth — twenty  temporary  ones  in  a 
perfect  state  of  development,  and  twenty-eight  permanent 
ones  imperfectly  developed,  and  placed  behind  the  tempo- 
ran'  teeth,  which  they  are  to  replace.  According  to  Mr. 
Saunders,  the  order  in  which  the  permanent  teeth  make 
their  appearance  is  as  follows:  At  seven  years,  the  four 
anterior  molars;  at  eight  years,  the  four  central  incisors; 
at  nine  years,  the  four  lateral  incisors ;  at  ten  years,  the  four 
anterior  bicuspids;  at  eleven,  the  four  posterior  bicuspids; 
at  twelve  to  twelve  and  a  half  years,  the  four  cuspids ;  and 
at  thirteen  to  fourteen  years,  the  four  second  molars — making 
the  whole  number  of  permanent  teeth  at  this  period  to  be 
twenty-eight.  The  four  remaining  (posterior  molars)  teeth — 
called  denies •  sapi entice — do  not  usually  appear  until  eighteen 
to  twenty-one  years  of  age.  As  a  rule,  the  teeth  of  the  lower 
jaw  are  cut  first,  but  there  are  many  exceptions;  nor  must 
it  be  forgotten  that  irregularities  often  occur  as  to  the  order 
of  their  appearance.  The  above  description  is  intended  to 
apply  only  to  the  average  cases. 

Let  us  now  take  one  or  two  examples  to  illustrate  the 
medico-legal  application  of  the  foregoing  rules.  Suppose 
the  skull    of  a  child  was  discovered,  in  the  jaws  of  which 


PROGRESS   OF    OSSIFICATION.  81 

were  twelve  permanent  teeth — eight  incisors  and  four 
molars,  we  should  decide  the  age  to  be  about  nine  years. 
If  the  jaws  contained  twenty-four  permanent  teeth — eight 
incisors,  four  molars,  eight  bicuspids  and  four  cuspids,  we 
should  conclude  the  age  to  be  about  thirteen  years ;  and  so 
on.  It  is  proper  here  to  remark,  that  there  are  two  diseases 
which  affect  the  growth  of  the  teeth,  viz.,  rickets  and 
syphilis.  In  a  rickety  child,  the  first  teeth  do  not  usually 
appear  until  after  the  twelfth  month,  whereas  in  cases  of 
congenital  syphilis,  the  teeth  appear  prematurely — before 
the  sixth  month;  but  they  present  a  peculiar  notched 
appearance ;  and  they  are  apt  to  be  brittle  and  to  crumble 
away  easily. 

The  progress  of  ossification  in  the  different  bones  of  the 
skeleton  affords  an  additional  test  of  its  age,  especially  in 
early  life.  According  to  Beclard,  the  degree  of  ossification 
in  the  lower  epiphysis  of  the  femur  affords  the  most  certain 
criterion  of  the  age  of  the  foetus,  and  of  the  new-born  child. 
Thus,  if  no  ossific  deposit  can  be  seen  in  this  cartilaginous 
epiphysis,  it  is  certain  that  the  fetus  has  not  attained  to  the 
eighth  month  of  uterine  life.  If  the  osseous  deposit  is  as 
large  as  a  poppy-seed,  it  is  probably  in  the  ninth  month  of 
foetal  existence;  and  if  it  has  acquired  the  diameter  of  a 
line  and  a  quarter,  to  one  and  a  half,  it  has  reached  the  full 
period.  If  the  point  of  ossification  measures  three  lines  or 
more,  it  may  be  assumed  that  the  child  had  survived  its 
birth  some  little  time. 

The  (average)  length  of  the  skeleton  of  a  new-born  child 
is  about  sixteen  inches.  At  the  end  of  the  first  year,  ossi- 
fication has  commenced  at  the  extremities  of  most  of  the 
long  bones ;  and  this  progressively  advances  from  year  to 
year,  until  the  whole  process  is  completed;  and  the  epiphyses 
of   all    the   lone   bones   are    united   to   their   shafts   at   full 


82  MEDICAL  JURISPRUDENCE. 

maturity,  which,  in  the  male,  may  be  considered  to  be 
twenty-four  years,  and  in  the  female,  twenty-two  years. 
After  this  period,  or  when  ossification  is  once  completed, 
it  is  difficult  to  determine  the  precise  age  by  an  examination 
of  the  bones  of  the  skeleton.  It  should,  however,  be 
remembered  that  the  different  bones  of  the  sternum  do  not 
unite  until  about  the  fortieth,  or  forty-fifth  year;  and  union 
between  the  sacrum  and  os  coccygis  is  not  usually  com- 
pleted until  fifty-five,  or  sixty  years  of  age. 

In  old  age,  the  bones  become  lighter  in  weight,  and  more 
brittle,  from  the  loss  of  animal  matter.  They  are  also 
darker  in  color ;  and  the  flat  bones  become  thinner,  from 
the  absorption  of  their  diploe.  In  the  skull  of  the  aged,  the 
sutures  are  more  or  less  obliterated ;  and  the  remaining 
teeth  present  a  worn  appearance,  and  a  yellowish  color.  If 
the  teeth  have  been  lost  (as  is  usually  the  case,  at  least  in 
this  country),  the  alveolar  processes  become  absorbed,  and 
the  lower  jaw  undergoes  a  well-marked  change  in  its  appear- 
ance, consisting  of  the  widening  of  the  angle  at  its  neck,  and 
the  shortening  of  the  vertical  diameter  of  its  body,  or  width, 
which  imparts  the  characteristic  senile  expression  to  the 
mouth  of  the  aged.  The  discovery  of  such  a  jawbone  would 
positively  determine  the  age  to  be  about  seventy  years,  or 
over. 

The  presence  or  absence  of  certain  teeth  in  the  head  has 
frequently  been  the  means  of  determining  the  identity  of 
the  body.  So  also,  the  presence  of  artificial  teeth,  with 
their  mechanical  appendages,  has  at  times  furnished  the 
strongest  corroborative  evidence  in  such  identification,  as 
in  the  celebrated  Parkman-YVcbster  case,  already  alluded  to, 
in  which  the  artificial  teeth,  discovered  undestroyed  by  the 
fire  in  the  grate,  where  the  head  had  been  burnt  up,  were 
positively  identified  by  the  dentist,  who  had  manufactured 


IDENTIFICATION    OF    THE   SEX.  83 

and  fitted  them  some  years  before.  So,  likewise,  the  remains 
of  the  Marchioness  of  Salisbury,  discovered  among  the 
burnt  ruins  of  Hatfield  House,  were  identified  by  the  jaw- 
bone having  gold  appendages  for  artificial  teeth  (Guy).  The 
importance  of  the  teeth  as  a  means  of  identification  is  shown 
in  the  case  of  the  late  French  Prince  Imperial,  whose  body 
had  been  so  much  disfigured  by  his  assailants,  that  its  iden- 
tification would  have  been  extremely  difficult  but  for  certain 
peculiarities  about  his  teeth  (Taylor,  Prin.  and  Prac.  Med. 
Jurisp.,  1884). 

II.  The  Sex. — This  can  usually  be  determined  from  the 
skeleton,  if  entire,  without  much  difficulty.  The  general 
appearance  of  the  male  and  female  skeleton  presents  many 
well  defined  points  of  difference,  which  need  not  here  be 
enumerated,  as  they  are  described  in  all  anatomical  works. 
Suffice  it  to  say  that  the  corresponding  bones  of  the  two 
differ  in  size,  weight,  strength,  and  prominence  of  their 
ridges  and  protuberances  which  mark  the  points  for  the 
insertion  of  muscles.  There  are  also  certain  recognized 
differences  in  the  head  and  thorax ;  but  it  is  in  the  pelvis 
that  the  most  characteristic  distinctions  are  observed.  The 
male  pelvis  is  narrower  and  deeper  than  that  of  the  female. 
In  the  latter,  the  ossa  il Hi  are  more  spread  out,  and  flatter, 
which  renders  the  superior  part  of  the  pelvis  more  capa- 
cious ;  the  sacrum  is  broader,  and  turned  more  backward ; 
the  arch  of  the  pubis  is  much  wider.  The  greatest  diameter 
is  the  bilateral ;  whereas  in  the  male,  the  antero-posterior  is 
the  greater.  The  foramen  ovale  is  triangular  in  the  female ; 
in  the  male,  it  is  more  oval.  Owing  to  the  greater  breadth 
of  the  female  pelvis,  the  acetabula  are  farther  apart  than  in 
the  male.  It  is  to  be  understood  that  these  peculiarities 
in  the  female  pelvis  are  not  exhibited  until   the  period  of 


84  MEDICAL    JURISPRUDENCE. 

puberty,  and  subsequently.  From  a  fragment  of  a  bone, 
merely,  it  would  certainly  be  hazardous  to  undertake  to 
determine  the  sex;  and  the  medical  jurist  should  exercise 
much  reserve  in  giving  an  opinion  in  such  a  case. 

III.  The  Stature. — If  the  whole  skeleton  has  been  pre- 
served, and  none  of  the  ends  of  the  long  bones  have  been 
lost  by  decay,  the  original  height  may  be  calculated  with 
tolerable  accuracy  by  arranging  the  bones  in  situ,  and  adding 
an  inch  and  a  half,  to  two  inches,  to  the  entire  length  of  the 
skeleton,  to  supply  the  loss  of  the  soft  parts.  But  even  here 
perfect  accuracy  cannot  be  attained,  chiefly  on  account  of 
variations  in  the  curve  of  the  spinal  column  in  different  in- 
dividuals. Dr.  Dwight*  assumes,  as  the  result  of  numerous 
observations,  that  the  total  height  of  the  intervertebral  carti- 
lages is  25.6  per  cent,  of  the  entire  length  of  the  spine.  As 
a  collateral  aid  in  estimating  the  stature,  we  may  regard  as 
correct  the  generally  accepted  rule,  that  the  top  of  the 
symphysis  of  the  pubes  is  about  the  centre  of  the  body  in 
average  women ;  while  in  men,  the  centre  is  a  little  below 
the  symphysis. 

The  attempt  has  frequently  been  made  to  estimate  the 
height  of  the  body  from  a  study  of  the  individual  long 
bones  of  the  skeleton  ;  but  no  reliance  can  be  placed  upon 
such  comparisons,  inasmuch  as  there  is  considerable  varia- 
tion in  the  length  of  these  bones  in  skeletons  of  the  same 
stature.  The  so-called  "  rules  of  proportion  "  of  certain 
writers  cannot  be  regarded  as  by  any  means  certain,  or 
authoritative.  In  case  the  skull  is  wanting,  the  rule  laid 
down  by  Dr.  Gould  is  "  to  find  the  height  of  the  spine  of 
the  seventh  cervical  vertebra  from  the  ground,  and  add  to 

*  The  Identification  of  the  Human  Skeleton,  by  Thomas  Dwight,  II. D. 
Boston.  1878. 


IDENTIFICATION    BY    FRACTURES,  ETC.  85 

this  9.95  inches,  which  is  the  average  height  from  this  point 
to  the  top  of  the  head."*  M.  de  St.  Luca  {Cosmos,  October 
2d,  1863,  quoted  by  Professor  Taylor)  states  that  an  approx- 
imative estimate  of  the  stature  may  be  had  by  measuring 
the  length  of  the  third  phalanx  of  the  middle  finger, 
thus:  this  phalanx  is  equal  in  length  to  one-fourth  that 
of  the  whole  finger,  or  one-eighth  that  of  the  hand,  in- 
cluding the  carpus.  The  arm  may  be  divided  into  five 
parts,  of  which  two  are  included  in  the  humerus,  two  in 
the  fore-arm,  and  one  in  the  hand.  The  total  length  of  the 
hand  is,  therefore,  one-fifth  that  of  the  arm.  Double  the 
length  of  the  arm  (or  the  two  arms  stretched  out  horizon- 
tally), added  to  the  length  of  the  two  clavicles,  together  with 
the  transverse  diameter  of  the  sternum,  is  equivalent  to  the 
whole  length  of  the  body.  In  applying  this  rule  to  practice, 
however,  we  must  not  forget  that  the  length  of  the  hand, 
and  especially  that  of  the  fingers,  varies  materially  in 
persons  of  the  same  height;  and  so  trifling  a  variation 
in  the  third  phalanx  of  the  middle  finger  as  the  one-thirty- 
second  of  an  inch  would,  according  to  this  method  of  calcu- 
lation, figure  up  as  great  a  difference  in  the  total  result,  for 
the  height  of  the  whole  body,  as  two  and  a  half  inches. 

The  existence  of  fractures,  deformities  and  callus  in  a 
skeleton  sometimes  affords  valuable  aid  in  its  identification, 
even  many  years  after  death.  In  relation  to  the  production 
of  callus,  it  is  well  understood  that  this  substance  is  the 
result  of  the  reparative  inflammation  of  bones,  and  that 
its  presence  on  a  bone  is  a  certain  indication  that  some  time 
must  have  elapsed  between  the  injury  and  the  death  of  the 
individual.  On  the  other  hand,  the  total  absence  of  callus 
in  a  fractured  bone,  indicating  that  no  time  had  been  given 
for  the  process  of  repair,  would  be  very  good  evidence  that 

*  Ibid. 


86  MEDICAL   JURISPRUDENCE. 

the  injury  was  the  immediate  precursor  of  death,  and  if  on 
the  skull,  the  probable  cause  of  death.  An  instructive  illus- 
tration of  this  is  given  by  Professor  Taylor  {Med.  Jurisp) 
in  the  case  of  an  Englishman  who  was  tried  in  India  for  the 
murder  of  a  native,  who  had  been  beaten  by  the  former  with 
a  stick,  with  the  allegation  that  his  rib  had  been  broken, 
thereby  causing  his  death.  To  substantiate  this  charge,  a 
skeleton  was  produced  which  had  been  dug  up  three  months 
subsequent  to  the  decease,  which  was  almost  completely 
denuded  of  flesh;  the  bones  clean  and  dry;  one  rib  frac- 
tured, with  a  deposit  of  callus  around  the  fracture.  The 
identity  of  these  bones  with  those  of  the  missing  man  was 
attempted  to  be  established  by  the  prosecution,  but  unsuc- 
cessfully, in  consequence  of  their  dry  and  denuded  state — a 
condition  altogether  incompatible  with  so  short  a  period  of 
time  as  three  months  since  death.  Moreover,  the  amount 
of  callus  thrown  out  made  it  evident  that  more  than  a  week 
must  have  elapsed  before  death  took  place,  which  event  was 
alleged  to  have  occurred  immediately  after  the  injury. 

Other  notable  instances  might  be  mentioned  of  the  iden- 
tification of  the  skeleton  by  means  of  the  above-mentioned 
marks,  or  peculiarities,  and  even  where  it  was  possible  to 
determine  the  actual  cause  of  the  violent  death.  In  the 
year  1823,  a  soldier  living  in  the  south  of  France  suddenly 
disappeared,  under  suspicious  circumstances.  Two  years, 
however,  elapsed  before  any  investigation  was  instituted  by 
the  proper  authorities.  Some  human  bones  were  then  dis- 
covered in  digging  in  the  garden  of  the  deceased  soldier. 
Of  course,  it  became  necessary  to  identify  these  remains.  It 
was  remembered  that  the  deceased  had  a  singular  personal 
deformity,  in  possessing  a  sixth  finger  on  the  right  hand,  and 
a  sixth  toe  on  the  left  foot.  On  examination,  it  was  ascer- 
tained that  the  fifth  metacarpal  bone  of  the  right  hand  was 


DURATION  OF  BONES  AFTER  BURIAL.  87 

shorter  and  broader  than  the  corresponding  bone  of  the 
other  hand,  and  further,  that  there  were  two  articulating  sur- 
faces on  its  digital  end,  indicating  clearly  the  existence  of  a 
supernumerary  finger.  In  the  same  way, the  fifth  metatarsal 
bone  of  the  left  foot  showed  two  distinct  articulating  faces 
on  its  digital  extremity,  indicating  the  existence  of  a  super- 
numerary toe.  Besides  this,  the  age,  sex  and  stature  of  the 
skeleton  corresponded  with  those  of  the  missing  man.  But 
even  further  than  this,  a  close  inspection  of  the  skull  revealed 
the  distinct  marks  of  a  depressed  and  radiated  fracture  of  the 
temporal  bone,  which  showed  no  sign  of  reparation  by  the 
formation  of  callus.  Evidently,  then,  death  had  occurred 
very  soon  after  the  fracture  of  the  skull,  and  in  all  proba- 
bility, as  the  direct  result  of  violence.  Upon  this  evidence, 
the  suspected  parties  were  tried  and  executed,  having  pre- 
viously confessed  their  crime. 

Sometimes,  on  the  exhumation  of  bones,  the  medico-lecral 
question  arises — how  long  have  they  been  buried  ?  It  is 
quite  impossible  to  give  more  than  an  approximative  reply 
to  this  question,  after  all  the  soft  parts  have  disappeared, 
which  commonly  requires  about  ten  years,  on  an  average. 
In  a  dry  soil,  bones  will  resist  decomposition  for  thirty  or 
forty  years  after  burial.  As  this  process  progresses,  they 
become  lighter  in  weight,  in  consequence  of  the  loss  of 
animal  matter,  and  the  color  externally  grows  darker.  The 
ends  gradually  become  brittle,  and  crumble  away,  and  finally 
the  shaft  of  the  bone  undergoes  a  similar  disintegration,  the 
mineral  matter  alone  remaining  unaltered,  and  constituting 
the  "dust"  to  which  the  animal  body  must  eventually  be 
reduced.  Devergie  states  that  the  bones  of  King  Dagobert 
were  found  in  a  state  of  tolerable  preservation,  enclosed  in  a 
leaden  coffin  and  sarcophagus,  at  St.  Denis,  after  the  lapse 
of  twelve  hundred  years;  and  Dr.  Taylor  mentions  that  the 


MEDICAL   JURISPRUDENCE. 

skeleton  of  William  Rufus  was  found  in  a  stone  coffin  at 
Winchester,  nearly  perfect,  after  seven  hundred  and  eighty 
years'  burial.  The  bones  of  Abelard  and  Heloise  were  so 
well  preserved,  that  after  a  lapse  of  five  hundred  years  the 
female  skeleton  could  readily  be  distinguished  from  the 
male. 

Even  if  the  bones  have  undergone  calcination,  as  when  a 
body  has  been  burned  with  a  view  of  destroying  its  identity, 
especially  in  cases  of  infanticide,  it  may  still  be  possible  to 
determine  whether  the  remains  are  human,  provided  the 
bones  preserve  their  proper  form,  and  have  not  been  reduced 
to  powder.  In  the  latter  case,  although  a  chemical  analysis 
of  the  ash  might  detect  the  calcium  phosphate,  this  would 
not  solve  the  mooted  question,  since  the  ash  of  human  and 
animal  bone  is  chemically  identical. 

Other  means  of  personal  identification  are  afforded  by  a 
microscopic  examination  of  the  hair,  and  the  fibres  of  various 
sorts  of  fabrics,  such  as,  cotton,  linen,  wool  and  silk  Human 
hair  discovered  on  a  weapon,  along  with  blood  stains,  affords 
strung  presumptive  evidence  of  murder,  or  violence.  So  also, 
fibres  of  cotton,  or  of  other  material,  found  on  weapons 
supposed  to  have  caused  death,  or  else  on  the  person  of  the 
accused,  suggest  a  strong  suspicion,  if  these  fibres  correspond 
to  the  clothes  of  the  deceased.  Thus,  a  case  is  mentioned 
by  Prof.  Taylor,  where  the  discovery  of  some  cotton  fibres, 
accompanied  by  a  blood-stain,  upon  the  edge  of  a  razor, 
found  near  a  woman  whose  throat  had  been  cut  while  in 
bed,  led  to  the  subsequent  detection  of  the  murderer.  In 
the  same  manner,  the  discovery  of  a  few  hairs  upon  the 
handle  of  a  knife,  on  which  also  were  marks  of  blood, 
enabled  a  London  microscopist  to  declare  that  these  hairs 
were  squirrel  hairs  ;  which  circumstance  further  led  to  tin: 
identification  of  the  murderess  of  a  child,  whose  throat  had 


IDENTIFICATION    BY    THE    HAIR.  89 

been  cut  with  a  knife,  which,  in  the  death  wound,  had  passed 
through  a  victorine  made  of  squirrel  fur,  worn  around  the 
child's  neck. 

In  case  of  rape  the  examination  of  the  hair  about  the  female- 
genitals  will  be  likely  to  show  the  presence  of  seminal  spots, 
and  consequently  of  spermatozoa,  which  cling  to  them  with 
great  tenacity. 

In  all  cases,  except  when  hairs  arc  to  be  examined 
for  spermatozoa,  they  should  be  washed  in  warm  water,  and 
then  thoroughly  dried,  afterwards  steeped  in  turpentine,  and 
finally  mounted  in  Canada  balsam.  They  should  then  be 
examined  with  a  magnifying  power  of  about  200  diameters. 
To  examine  hairs  for  spermatozoa,  moisten  first  of  all  with 
a  drop  of  ammonia  solution,  and  examine  under  a  micro- 
scope after  the  liquid  has  evaporated  (Tidy). 

For  the  identification  of  hairs,  human  or  other,  it  is 
desirable  to  have  at  hand  specimens  of  various  kinds  of 
these,  properly  mounted,  for  comparison.  Hairs  resist 
putrefaction  for  an  indefinite  length  o[  time,  which  fact  aids 
greatly  in  their  examination  for  medico-legal  purposes.  It 
should  also  be  remembered  that  hair  is  affected  differently 
by  different  reagents.  Strong  alkalies  dissolve  it;  acids 
roughen  it ;  alcohol  causes  it  to  look  clearer ;  chlorine 
water  bleaches,  and  rots  it. 

The  size  of  hairs  from  different  parts  of  the  human  body, 
as  well  as  from  different  individuals,  varies  considerably ; 
thus,  the  hairs  from  the  head  are  finer  than  the  eyelashes, 
but  coarser  than  the  hairs  from  the  arm.  There  is  also 
considerable  difference  in  the  size  of  the  hairs  of  the  various 
lower  animals.  The  shape  and  microscopical  appearance 
of  human  and  other  hair  are  figured  in  some  of  the  larger 
works. 

The  main  medico-legal  questions  connected  with  the 
5* 


90  MEDICAL   JURISPRUDENCE. 

identification  of  hairs  are  :  (i)  Is  the  hair  human,  and  from 
what  part  o(  the  body  ?  (2)  Does  it  correspond  with  the 
hair  of  the  murderer,  or  of  the  victim  ?  (3)  Has  its  color 
been  naturally,  or  artificially  changed  ?  It  should  be  re- 
membered that  gray  hair  is  not  unfrequently  found  on 
comparatively  young  persons,  and  that  undoubted  instances 
have  occurred  of  the  sudden  bleaching  of  the  hair  through 
fright  or  grief.  As  regards  the  artificial  coloring  of  the 
hair,  it  is  well  known  that  this  is  one  of  the  means  of 
disguise  most  commonly  adopted  by  criminals,  in  order  to 
elude  detection. 

The  common  hair  dyes  for  coloring  light  or  red  hair  black 
or  brown,  are  composed  of  the  salts  of  lead,  silver,  or  bis- 
muth. Hair  thus  colored  may  easily  be  detected  by  soaking 
it  in  nitric  acid,  which  dissolves  out  the  mineral,  which  may 
then  be  identified  by  the  appropriate  tests.  It  is  more  diffi- 
cult to  bleach  or  whiten  the  hair,  than  to  darken  it.  This  is 
usually  effected  by  first  washing  it  in  an  alkali,  to  remove 
the  greasy  matter,  and  then  soaking  it  in  chlorine  water, 
which  will  lighten  its  tint  in  a  few  hours;  but,  at  the  same 
time,  it  will  render  it  very  brittle,  and  impart  its  peculiar 
odor  to  it. 

In  all  artificially  colored  hair,  the  fraud  can  be  detected 
by  closely  watching  the  new  growth,  which  will  be  of  a 
different  color  from  the  other  portions;  and  also  by  chemi- 
cal tests. 

The  fibres  of  cotton,  linen,  wool  and  silk  all  present  well- 
marked  differences,  when  viewed  under  the  microscope. 
The  cotton  fibre  is  in  the  form  of  a  flattened  band,  with 
thickened  borders,  and  is  spiral,  or  twisted  upon  itself. 
Linen  consists  of  round  fibres,  having  a  firm  consistency, 
with  jointed  transverse  markings  at  unequal  distances, 
somewhat  resembling  those  on  the  India  cane,  and  taper- 


IDENTIFICATION    OF    FIBRES.  91 

ing  to  a  point.  Silk  fibre  has  the  appearance  of  straight, 
well-defined  cylinders,  free  from  all  markings,  and  refracting 
light  powerfully.  Wool  fibre  is  irregular,  wavy,  and  of 
unequal  thickness.  The  fibres  of  hemp  resemble  those  of 
flax  (linen),  but  are  coarser;  and  when  boiled  in  nitric  acid 
they  exhibit  no  spiral  streaks,  but  swell  and  become  brittle. 
The  identification  of  blood  stains  and  seminal  spots  will  be 
treated  of  later. 


92  MEDICAL  JURISPRUDENCE. 


CHAPTER  VI. 

THE  CAUSES  rRODUCING  VIOLENT  DEATH. 
These  ma)'  be  considered  under  the  following  heads  :- 
I.  Wounds,  including  Burns. 


II.  Suffocation. 

III.  Strangulation. 

IV.  Hanging. 
V.  Drowning. 


VI.  Lightning. 
VII.  Heat  and  Cold. 
VIII.  Starvation. 
IX.  Poisoning. 


section  i. 
VIOLENT  DEATH  FROM  WOUNDS. 
DEFINITION     OF    A     WOUND. — DANGER    OF. — EXAMINATION     OF     THE 
BODY. — RESULTS    OF   THE    INJURY. — ABSENCE    OF  EXTERNAL  MARKS 

OF     VIOLENCE. — WOUNDS     MADE     BEFORE     AND     AFTER     DEATH. 

HEMORRHAGE. — ECCHYMOSES. — CLASSIFICATION.— HOMICIDAL,  SUI- 
CIDAL   AND    ACCIDENTAL   WOUNDS. 

The  surgical  and  the  legal  definition  of  a  wound  are  not 
identical.  The  former  idea  of  the  term  is  "a  solution  of 
continuity  of  the  soft  parts,  occasioned  by  external  vio- 
lence." According  to  this  meaning,  there  must  be  a  rup- 
ture of  the  skin,  or  the  mucous  membrane,  to  constitute  a 
•wound.  But  this  would  evidently  exclude  internal  injuries, 
such  as  rupture  of  the  liver,  spleen,  or  heart,  fractures  and 
luxations  unaccompanied  by  external  lesion;  hence,  the 
legal  definition  of  a  wound  is  more  comprehensive;  it  em- 
braces all  injuries  of  the  body,  whether  external  or  internal, 
with  or  without  a  solution  of  continuity  of  the  skin,  pro- 
duced suddenly  by  external,  or  mechanical  violence.  The 
latter  meaning  of  the  term  wound  is  evidently  its  proper 
medico-legal  application,  although  it  may  not  strictly  accord 
with  the  surgical  definition. 


WOUNDS    A    CAUSE    OF    DEATH.  93 

A  distinction  is  sometimes  made  between  mortal  and  uou- 
mortal  wounds,  or  between  wounds  dangerous  and  not  dan- 
gerous to  life,  and  the  medical  witness  is  asked  to  give  his 
opinion  on  this  subject.  But  he  should  be  guarded  in  his 
answer,  since  it  is  well  known  that  many  wounds  at  first 
considered  as  comparatively  trivial,  subsequently  assume  a 
dangerous,  and  even  fatal  character.  Of  course,  in  many 
cases  there  can  be  no  difficulty  in  pronouncing  upon  the 
dangerous  or  mortal  character  of  a  wound,  as,  for  instance, 
if  the  heart  or  the  great  vessels  have  been  wounded,  in 
compound  fracture  of  the  skull,  in  wounds  of  the  internal 
viscera,  etc.  The  danger  of  a  wound,  it  may  be  remarked, 
depends  upon  a  variety  of  circumstances,  all  of  which 
should  be  considered,  such  as  its  position;  its  locality  in  rela- 
tion to  the  great  vessels  and  nerves;  the  kind  of  weapon 
by  which  it  was  inflicted;  the  amount  of  hemorrhage;  the 
age,  constitution  and  general  health  of  the  subject ;  the  cir- 
cumstances (favorable  or  unfavorable)  for  treatment,  and 
other  considerations,  all  of  which  must  be  taken  into  account 
as  important  factors  in  the  prognosis.  Medical  testimony 
is  not  usually  required,  except  in  case  of  a  fatal  termination. 
An  exception  to  this  may,  however,  occur  in  the  case  of  an 
assault,  where  the  character  of  the  injury  (whether  dangerous 
or  trivial)  might  decide  as  to  the  propriety  of  accepting  bail 
for  the  prisoner. 

In  case  of  death  from  a  wound,  the  medical  examiner 
should  never  theorize  as  to  the  manner  of  its  causing  the 
death ;  and  he  should  give  his  opinion  only  after  a  very 
careful  post-mortem  examination  of  the  body.  Moreover, 
this  examination  should  not  be  confined  simply  to  the 
wounded  portion  of  the  body,  but  all  the  cavities  and  organs 
should  be  inspected,  since  it  might  be  affirmed  that  a  natural 
cause  of  death   might  have  existed   in  that  very  part  which 


9-J  MEDICAL   JURISPRUDENCE. 

was  neglected  by  the  examiner.  Such  neglect  has  often 
been  the  means  of  securing  the  release  of  the  prisoner,  inas- 
much as  it  occasioned  a  doubt  as  to  the  real  cause  of  death, 
in  the  minds  of  the  jury.  It  may  even  be  proper  to  examine 
the  stomach  for  poison  in  all  doubtful  cases ;  as  shown  by 
the  oft  quoted  instance  related  by  Wildberg,  of  the  girl  who 
was  beaten  by  her  father  for  stealing,  and  who  died  shortly 
afterwards,  apparently  from  the  effects  of  the  blows,  but  in 
whose  stomach  a  considerable  quanity  of  arsenic  was  found. 
She  had  swallowed  the  poison  soon  after  committing  the 
theft,  fearing  her  father's  anger.  The  man  was  discharged. 
In  a  similar  manner,  it  sometimes  happens  that  a  person, 
after  taking  poison  with  suicidal  intent,  may  destroy  himself 
by  another  means,  as  by  a  gunshot  wound,  by  drowning,  or 
by  throwing  himself  from  a  window  or  a  precipice. 

The  examination  of  the  wound  includes  the  observation 
of  its  situation,  extent  and  direction ;  the  presence  or  absence 
of  effused  blood,  whether  liquid  or  coagulated,  and  the  pres- 
ence of  ecchymoses  ;  the  condition  of  the  edges  of  the 
wound,  whether  everted  or  not ;  whether  adhesion  has  com- 
menced ;  the  presence  of  granulation,  inflammation,  suppu- 
ration, or  gangrene ;  whether  it  was  inflicted  before,  or  after 
death  ;  whether  there  was  loss  of  substance  ;  hernia  of  the 
intestinal  organs,  etc.  There  should  also  be  an  inspection 
of  the  clothes  of  the  deceased,  to  ascertain  if  the  rents  or 
stabs  in  these  correspond  with  the  wounds  of  the  body ;  and 
if  a  weapon  be  discovered,  it  should  be  carefully  compared 
with  the  wound. 

It  sometimes  happens,  in  cases  of  severe  injury,  that 
death  has  resulted  from  internal  lesions,  with  few  or  no 
external  marks  to  indicate  them.  According  to  Casper, 
this  is  of  frequent  occurrence  in  severe  internal  lacerations 
occasioned  by  violence.     He  cites  a  case  of  this  character. 


WOUNDS    BEFORE    AND    AFTER    DEATH.  95 

A  wagoner,  in  guiding  his  team  with  a  loaded  wagon  down 
a  hill,  was  accidentally  crushed  against  a  tree  on  the  road. 
He  was  found  dead  the  next  morning.  The  only  external 
injuries  were  a  slight  abrasion  upon  the  left  arm,  and  one 
upon  the  right  temple.  On  opening  the  body,  however,  the 
most  striking  evidences  of  violence  were  discovered.  From 
the  spinal  canal,  about  a  quart  of  blood  escaped.  The 
spinous  processes  of  the  first  thoracic  vertebrae  were  broken 
off.  The  left  pleural  cavity  contained  about  thirty  ounces 
of  fluid  blood.  The  pericardium  was  torn  completely 
across,  and  the  heart,  severed  from  its  large  vessels,  lay 
almost  entirely  loose  in  the  cavity  of  the  thorax.  The  open 
ends  of  the  aorta  and  pulmonary  artery  were  distinctly 
visible.  The  left  lung  was  entirely  torn  through  its  middle 
portion ;  and  in  the  right  lobe  of  the  liver  was  a  laceration 
two  inches  long  and  half  an  inch  deep  {GcricJit.Med.  I,  122). 
The  distinction  between  wounds  made  before  and  after 
death  should  be  carefully  noticed.  Wounds  inflicted  before 
death  may  be  recognized  by  the  following  signs  :  (1)  Incised 
wounds  exhibit  everted  edges,  arising  from  the  elasticity  of 
the  skin  and  subjacent  muscles,  with  considerable  hemor- 
rhage, usually  of  an  arterial  character;  the  spots  of  arterial 
blood  which  have  spouted  on  neighboring  surfaces  are  of  a 
peculiar  comet-like  shape.  Coagula  are  more  or  less 
abundant  in  the  wound,  and  around  it.  The  surrounding 
tissues  are  more  or  less  infiltrated  with  blood.  If  some 
days  have  elapsed  before  death,  evidences  of  vital  reaction 
will  be  shown,  such  as  partial  healing,  granulation,  suppu- 
ration, or  sloughing.  If  the  wound  was  made  immediately 
after  death — within  a  few  minutes — there  may  be  some 
retraction  of  the  skin,  and  some  slight  bleeding,  with  few 
or  no  coagula,  which  are  of  loose  texture.  There  is  little 
or  no  staining  of  the  surrounding  tissues,  and  never  any 


!><;  MEDICAL   JURISPRUDENCE. 

attempt  at  repair.  If  the  wound  be  made  ten  or  twelve 
hours  after  death,  there  will  be  no  e version  of  its  edges,  no 
hemorrhage,  except  of  a  slight  venous  character,  and  no 
surrounding  infiltration.  The  experiments  of  Professor 
Taylor  and  Mr.  Aston  Key  upon  amputated  limbs  con- 
firm the  above  description.  The  amount  of  hemorrhage 
accompanying  an  incised  wound  affords  a  pretty  good 
criterion  as  to  whether  it  was  inflicted  before,  or  after  death. 
Comparatively  little  bleeding  accompanies  wounds  made 
after  death,  and  this  is  chiefly  venous ;  the  arteries  yield 
little  or  none,  while  in  the  living,  the  hemorrhage  is  chiefly 
arterial.  In  a  case  of  murder  reported  by  Casper,  as  also 
in  the  case  of  Greenacre,  in  England  in  1837,  where  the 
head  of  the  victim  was  severed  from  the  body,  the  fact  that 
the  head  was  completely  drained  of  blood  led  to  the  con- 
clusion that  the  decapitation  had  been  done  during  life,  and 
that  there  must  then  have  been  a  copious  hemorrhage  to 
account  for  the  absence  of  the  blood  after  death. 

(2)  In  lacerated  and  contused  wounds,  the  distinction  is 
not  so  obvious  as  in  incised  wounds.  Lacerations  are  not 
always  accompanied  by  bleeding,  but  there  will  always  be 
more  or  less  coagula  present;  and  if  the  person  survives  a 
few  days  there  will  be  evidences  of  vital  reaction,  such  as 
suppuration  and  granulation,  sloughing  or  gangrene,  all 
of  which  are  absent  in  such  wounds  inflicted  after  death. 

Co/ttttscd  wound*  made  during  life  are  chiefly  distinguished 
by  the  amount  of  effused  blood  in  the  cellular  tissue  under 
the  skin  (ecchymosis).  This  arises  from  the  rupture  of 
small  vessels,  and  is  manifested  by  the  well-known  "black 
and  blue"  discoloration  produced.  If  the  effusion  of  blood 
is  rapid,  the  spot  is  of  a  dark  red,  at  first ;  if  slower,  the 
discoloration  is  deep  blue,  or  violet.  In  some  cases  of  even 
violent   contusion,  there  may  be  no  appearance  of  external 


ECCHYMOSES.  97 

ecchymosis.  Again,  it  is  not  always  manifested  immedi- 
ately over  the  seat  of  the  contusion,  but  at  a  little  distance 
from  it,  especially  if  the  surrounding  tissue  is  loose.  Familiar 
illustrations  of  this  are  afforded  in  the  case  of  a  blow  over 
the  eye,  producing  an  ecchymosis  of  the  lower  lid ;  and  of 
a  blow  over  the  lower  portion  of  the  abdomen  being  at- 
tended with  ecchymosis  of  the  scrotum.  The  presence  of 
ecchymoses,  then,  in  cases  of  contused  wounds,  may  be  re- 
garded as  pretty  good  evidence  of  the  ante-mortem  character 
of  the  injury,  while  its  absence  is  not  necessarily  an  indica- 
tion that  the  wound  was  post-mortem.  The  experiments 
of  Sir  R.  Christison  upon  the  dead  body  go  to  show  that 
if  the  contusion  be  made  very  soon  after  death,  and  while 
the  body  is  still  warm,  the  resulting  appearances  strongly 
resemble  those  produced  by  ante-mortem  contusion ;  with 
this  difference,  however,  that  the  effusion  is  usually  imme- 
diately beneath  the  skin,  and  not  in  the  areolar  tissue ;  also, 
that  there  is  an  absence  of  coagula,  and  of  swelling. 

Ecchymosis  is  usually  superficial,  and  may  appear  very 
shortly  after  the  injury;  or  it  may  be  deep-seated,  and  not 
visible  at  all.  In  some  instances  it  is  not  manifested  until 
after  death,  as  in  the  case  of  a  man  who  died  from  rupture 
of  the  bladder,  resulting  from  the  kick  of  a  horse,  thirty-five 
hours  after  the  injury.  No  discoloration  of  the  abdomen 
was  observed  until  after  his  death.  Neither  can  the  quan- 
tity of  blood  effused,  nor  the  extent  of  the  injury  be  always 
estimated  by  the  amount  of  the  discoloration.  This  is  well 
illustrated  in  the  case  of  the  wagoner  who  was  crushed  to 
death,  as  mentioned  by  Casper,  and  which  was  alluded  to 
above. 

Another  important  fact  relative  to  ecchymoses  is  the 
clicDige  of  color  which  accompanies  them,  since  this  may 
serve  to  indicate  the  probable  date  of  the  contusion.      In 


98  MEDICAL   JURISPRUDENCE. 

about  twenty-four  hours  the  blue  or  livid  margin  of  the 
bruise  becomes  lighter,  or  of  a  violet  color,  which  gradually 
changes  to  green  and  yellow.  During  these  alterations  of 
color,  the  spot  may  become  larger,  but  the  central  portion 
remains  always  darker  than  the  margins.  These  changes 
of  color  are  believed  to  be  due  to  a  dilution  of  the  serum 
of  the  blood  by  the  fluid  of  the  cellular  membrane,  and  its 
gradual  dispersion  throughout  the  cells.  It  is  finally  ab- 
sorbed, and  the  color  entirely  disappears.  In  general,  it 
shows  itself  within  twelve  hours  after  the  contusion  ;  the 
violet  color  within  three  days;  the  green  from  the  fifth  to 
sixth  day;  the  yellow  from  the  eighth  to  tenth  day;  and  in 
healthy  persons,  the  complete  disappearance  of  the  spot 
occurs  from  the  twelfth  to  fourteenth  day.  The  changes 
are  more  rapid  in  the  young  than  in  the  old,  and  depend 
also  on  the  degree  of  the  contusion.  The  above  changes  of 
color  never  appear  in  contusions  on  the  dead,  which  cir- 
cumstance constitutes  another  diagnostic  mark. 

It  is  also  important  not  to  mistake  the  ecchymosis  pro- 
ceeding from  natural  causes,  such  as  scurvy,  petechias 
and  purpura,  from  that  occasioned  by  blows.  The  former 
may  usually  be  distinguished  by  being  confined  to  the 
superficial  layers  of  the  skin,  and  by  their  presence  also  on 
the  internal  mucous  membranes,  together  with  the  absence 
of  swelling,  and  the  fluidity  of  the  blood. 

According  to  Devergie,  ecchymoses  are  often  concealed 
on  the  bodies  of  the  drowned,  when  first  they  are  removed 
from  the  water,  owing  to  the  sodden  state  of  the  skin  ;  they 
may  become  apparent  only  after  the  body  has  been  exposed 
for  some  days,  and  the  water  has  evaporated. 

(3)  In  punctured  and  penetrating  wounds,  the  diagnosis 
between  those  inflicted  before,  and  those  produced  after 
death,  is  usually  not  difficult.     The  former  are  attended  with 


INCISED    WOUNDS.  99 

more  or  less  hemorrhage,  and  often  exhibit  signs  of  vital 
and  reparative  reaction,  such  as  inflammation  and  suppura- 
tion, or  gangrene.  The  latter  are  destitute  of  all  these. 
For  example,  a  stab  made  into  the  left  ventricle  of  the  heart 
after  death  is  followed  by  no  hemorrhage. 

It  is  not  always  possible  for  a  medical  witness  to  state 
positively  that  a  wound  was  caused  by  a  particular  weapon  ; 
but  it  is  desirable,  if  possible,  to  establish  the  relation  of  the 
injury  with  its  supposed  cause  ;  thus,  an  incised  wound  would 
naturally  be  referred  to  a  cutting  weapon ;  a  penetrating 
wound  to  a  pointed  one  ;  and  a  contused  wound  to  a  blunt 
instrument.  But  caution  should  be  observed  in  giving  an 
opinion  on  this  subject,  especially  in  case  of  contused 
wounds. 

Incised  wounds  are  characterized  by  the  regularity  and 
evenness  of  the  cut.  This  usually  serves  to  distinguish 
them  from  wounds  made  by  glass  and  crockery  ware,  or 
nails,  which  are  generally  irregular  and  uneven.  But  in 
some  instances,  the  cuts  produced  by  broken  glass  or  china 
exactly  resemble  incised  wounds.  In  stabs,  the  shape  of 
the  wound  may  often  indicate  the  character  of  the  weapon, 
whether  double-edged  or  not.  But  where  the  weapon  has 
penetrated  obliquely  through  the  tissues,  and  when  these 
have  been  stretched,  the  shape  of  the  wound  will  not  exhibit 
this  correspondence.  So  also,  a  wound  made  in  parts  where 
the  skin  is  wrinkled  may  suggest  the  idea  of  several  distinct 
wounds,  as  in  the  neck.  It  must  not  be  overlooked  that 
superficial  incised  wounds  may  give  rise  to  dangerous,  or 
even  fatal  hemorrhage.  And  also,  that  it  is  not  always  pos- 
sible, in  such  cases,  to  determine  the  direction  of  the  incision, 
i.e.,  whether  made  from  right  to  left,  or  the  reverse.  And 
yet,  as  remarked  by  Casper,  this  fact  might  have  a  most 
important  medico-legal  significance  in  determining  the  ques- 


100  MEDICAL   JURISPRUDE1 

tion  whether  the  wound,  as  in  cutting  the  throat,  was  homi- 
cidal or  self-inflicted.  The  attendant  circumstances,  however, 
might  throw  some  light  upon  it,  such  as  the  presence  of 
blood  on  the  right  or  left  hand,  or  cuts  on  certain  parts  of 
the  clothing  of  the  deceased. 

Lacerated  and  contused  wounds  do  not  afford  the  same 
facility  for  identifying  the  weapon  as  incised  wounds.  From 
simply  inspecting  them,  the  medical  witness  will  not  gener- 
ally be  able  to  indicate  the  precise  weapon,  or  cause.  He 
may,  indeed,  be  able  to  say  that  it  was  not  produced  by  a 
cutting  instrument.  But  a  blow  made  by  a  blunt  weapon 
upon  the  skull,  or  over  the  zygoma,  may  give  rise  to  a  cut 
which  strongly  resembles  an  incised  wound,  though,  as  a 
rule,  the  division  of  the  parts  is  not  as  straight  and  regular 
as  in  the  latter,  and  the  angles  of  the  wound  are  less  acute. 
Moreover,  in  the  contused  wounds  there  is  more  or  less 
swelling,  and  extravasation  of  blood  into  the  adjoining 
parts ;  and,  at  times,  the  existence  of  irregular  fracture  and 
internal  hemorrhage. 

In  the  case  of  a  fatal  contused  wound  of  the  head,  it  has 
been  judicially  decided  that  it  makes  no  difference  as  to  the 
guilt  of  the  accused,  whether  he  produced  the  death  of  his 
victim  by  a  direct  blow  upon  the  head,  or  indirectly,  by 
causing  him  to  fall  upon  a  stone,  or  other  hard  substance, 
which  produced  the  fracture,  or  contusion. 

As  before  mentioned,  rupture  of  the  internal  organs — the 
liver,  spleen,  heart,  lungs  and  kidneys — is  a  frequent  result 
of  contusions.  Fracture  of  the  base  of  the  skull  is  some- 
times caused  by  severe  contusion  of  the  head.  Wharton 
and  Stille  (Med.  Jurisp.,  Book  V,  p.  660)  allude  to  the  fact 
that  spontaneous  wounds  sometimes  occur  in  the  labia  and 
vagina  of  pregnant  women,  which  might  give  rise  to  suspi- 
cion of  assault.     Also,  that   in   such  women  accidents   of 


EXAMINATION    OF    THE    CLOTHES.  K)  1 

different  kinds  are  frequently  attended  with  profuse  hemor- 
rhage from  the  pudenda. 

It  is  evident  from  what  has  been  said  in  reference  to  the 
difficulty  of  always  connecting  a  contused  wound  with  the 
precise  instrument  that  caused  it,  that  the  witness  should 
avoid  committing  himself  upon  the  question.  In  some 
instances,  however,  the  shape  of  the  contused  wound,  espe- 
cially a  depressed  fracture  of  the  skull,  will  enable  us  to 
come  to  a  correct  conclusion  on  the  subject.  Some  years 
ago  the  author  was  called  upon,  as  an  expert,  to  testify  as  to 
the  probable  cause  of  a  depressed  fracture  of  the  temporal 
bone  of  a  man  who  had  been  struck  during  a  melee.  The 
question  was,  whether  the  injury  had  been  inflicted  by  the 
fist  merely  (as  was  alleged),  or  by  an  instrument  like  a 
loaded  cane,  or  billy.  There  was  good  reason  for  believing 
that  the  latter  instrument,  in  the  hands  of  another  person, 
was  the  real  cause  of  his  death,  owing  to  the  private  con- 
fession of  a  comrade  of  the  prisoner.  The  fractured  bone 
was  produced  in  court.  The  depression  was  well-marked, 
a  quarter  of  an  inch  deep,  exactly  corresponding  to  the 
loaded  end  of  the  billy  ;  no  radiating  fissures  (as  would 
most  probably  have  resulted  from  a  blow  of  the  fist). 
Although  the  opinion  of  the  author,  founded  on  the  above 
facts,  was,  that  the  fatal  blow  had  not  been  inflicted  by  a 
fist,  but  by  a  billy ',  two  physicians  on  the  other  side  thought 
differently;  and  the  judge  dexterously  solved  the  mooted 
question  by  asserting  that,  in  such  cases,  one  expert  was 
about  as  good  as  another  ;  and  inasmuch  as,  in  the  present 
trial  there  were  two  against  one,  he  would  decide  in  favor  of 
the  majority!  and  so  he  did,  and  the  prisoner  (possibly  an 
innocent  man)  was  convicted,  and  sent  to  the  penitentiary 
for  five  years. 

The  examination  of  the  clothes  of  the  deceased  constitutes 


102  MEDICAL   JURISPRUDENCE. 

an  important  part  of  the  legal  physician's  duty,  as  this  may 
throw  light  upon  the  mode  in  which  the  wound  had  been 
made,  from  the  character  of  the  cuts,  or  stabs  observed  upon 
them.  So  likewise,  marks  of  blood,  dirt,  grass,  or  other 
substances,  on  the  clothing  may  afford  valuable  indications 
in  the  same  direction.  Contused  wounds  by  bludgeons 
may,  however,  occasion  considerable  laceration  of  the 
muscles,  or  even  severe  fractures,  without  tearing  the  dress. 
Professor  Taylor  {Med.  Jierisp)  mentions  an  instructive 
case,  showing  the  importance  of  comparing  the  articles  of 
dress  with  the  injuries  which  may  have  proved  fatal.  A 
woman,  aged  sixty,  was  found  one  morning  dead  in  her  bed. 
She  had  been  seen  in  her  usual  health  on  the  previous 
night.  On  inspection,  there  were  found  two  indentations  in 
the  right  parietal  bone,  and  a  large  clot  of  blood  in  this 
situation,  beneath  the  skin,  together  with  a  fracture  of  the 
bone,  four  inches  in  extent.  Beneath  the  bone,  on  the  dura 
mater,  were  found  nearly  three  ounces  of  clotted  blood. 
On  the  evening  before  her  death,  she  had  been  suddenly 
knocked  down  on  the  public  road,  by  a  man  accidentally 
running  against  her.  She  fell  heavily  on  the  back  of  her 
head,  appeared  stunned,  was  raised  upon  her  feet,  and,  after 
swallowing  some  brandy,  recovered  sufficiently  to  walk 
home,  a  mile  and  a  half,  and  eat  her  supper.  She  was 
found  next  morning  dead  in  bed.  There  was  a  suspicion  of 
murder,  in  this  case,  against  a  fellow  lodger;  but  when  the 
bonnet  worn  by  the  woman  was  produced  at  the  inquest, 
two  indentations  were  discovered  on  the  back  part  of  it, 
corresponding  to  those  on  the  skull  of  the  deceased.  The 
indentations  on  the  bonnet,  moreover,  contained  dust  and 
dirt,  thereby  confirming  the  statement  of  witnesses  who  had 
seen  her  fall,  and  rendering  it  highly  probable  that  this  fall 
was  the  real  cause  of  the  fatal  fracture,  and  effusion  of  blood. 


NATURE    AND    EXTENT    OE    THE    WOUND.  103 

It  also  illustrates  the  well-known  fact  that  a  person  may 
receive  a  fracture  of  the  skull  ending  in  effusion,  which  may 
not  prove  fatal  for  many  hours  after  the  accident,  and  which 
may  not  have  prevented  the  individual  from  walking  a  con- 
siderable distance  after  the  injury. 

Was  the  wound  homicidal,  suicidal,  or  accidental?  This 
important  medico-legal  question  cannot  always  be  settled 
by  medical  testimony  alone,  though  there  are  man^points 
in  which  it  is  of  the  greatest  aid  to  the  legal  authorities. 
These  are  as  follows  : — 

1.  The  Situation  of  the  Wound. — Suicidal  wounds  are 
usually  inflicted  upon  the  most  accessible  parts  of  the  body, 
such  as  the  head,  neck,  breast  and  abdomen.  If  by  fire- 
arms, the  part  usually  selected  is  the  head  (mouth,  forehead 
or  temple),  or  over  the  heart ;  if  by  a  cutting  instrument,  the 
throat  or  heart.  The  discovery,  therefore,  of  wounds  on  a 
part  of  the  body  difficult  to  reach  by  the  individual  himself, 
as  the  back,  would  certainly  not  be  suggestive  of  suicide. 
But  an  exception  must  be  made  here  as  regards  the  insane, 
who  are  well  known  to  destroy  themselves  by  self-inflicted 
wounds  of  the  most  extraordinary  character,  on  the  back  of 
the  head  and  neck ;  by  striking  the  head  against  some  solid 
substance  ;  or  precipitating  themselves  from  a  height.  An 
insane  person  has  been  known  to  shoot  himself  with  a  pistol 
fired  from  behind  the  ear.  The  situation  of  the  wound  is, 
therefore,  only  suggestive  of  its  origin,  since  it  is  quite  pos- 
sible that  an  assassin  might  inflict  a  death  wound  upon  his 
victim  in  such  a  situation  designedly,  in  order  to  deceive, 
and  thus  elude  the  suspicion  of  homicide.  Accidental 
wounds  are  usually  met  with  on  exposed  parts  of  the  body. 

2.  Nature  and  Extent  of  the  Wound. — Suicide  is  rarely 
inflicted  by  contused   wounds,  but    usually  by   incised   or 


I'M  MEDICAL    JURISPRUDENCE. 

penetrating  ones.  Exceptions  occur,  as  when  a  person 
throws  himself  out  of  a  window,  or  from  a  height;  and  in 
some  remarkable  instances  of  self-destruction,  by  butting 
the  head  against  a  wall,  and  subsequently  chopping  it  with 
a  hatchet.  In  the  case  of  the  insane,  there  is  no  accounting 
for  the  variety  in  the  nature,  and  extent  of  the  wounds  in- 
flicted for  the  purpose  of  self-destruction.  This  fact  ought 
to  be  remembered,  since,  if  the  bodies  of  such  persons 
should  afterward  be  discovered,  and  nothing  be  known  of 
their  previous  histories,  serious  errors  in  relation  to  the  real 
origin  of  the  wounds  might  result. 

Incised  Wounds  of  the  Throat  art  usually  regarded  as  in- 
dicating suicide;  but  it  is  well-known  that  murderers  fre- 
quently destroy  their  victims  by  cutting  their  throats.  As 
to  the  extent  of  the  wound,  it  is  commonly  supposed  that  a 
suicidal  incision  of  the  throat  does  not  reach  as  deeply  as  a 
homicidal  one  of  the  same  character;  but  instances  are  not 
wanting  where  a  determined  suicide  has  severed  the  throat 
down  to  the  vertebrae.  Again,  irregularity  in  the  cut  of  the 
throat  has  been  deemed  by  some  as  indicating  homicide 
rather  than  suicide,  under  the  idea  of  resistance  on  the  part 
of  the  victim;  but  it  is  evident  that  the  irregularity  might 
have  resulted  equally  from  nervousness,  or  indecision  in 
inflicting  the  wound,  on  the  part  of  the  deceased. 

The  nature  and  extent  of  the  wound  or  injury  may  serve 
to  distinguish  accident  from  homicide.  Thus,  if  numerous 
wounds  or  bruises  are  discovered  in  opposite  sides  of  a 
dead  body,  the  presumption  would  be  in  favor  of  homicide; 
and  when  the  accused  attempts  to  ascribe  the  death  of  his 
victim  to  a  fall,  the  nature  of  the  wounds  might  be  such  as 
positively  to  contradict  his  assertions. 

3.  Direction  of  the  Wound. — This  will  often  enable  us  to 
distinguish  between  a  homicidal  and  an  accidental  wound, 


WOUNDS  OF  THE  THROAT.  105 

rather  than  to  decide  upon  its  suicidal  character.  Thus,  if 
death  has  occurred  from  a  stab,  inflicted  downward  from 
the  upper  part  of  the  thorax,  and  penetrating  the  heart, 
and  it  was  attempted  on  the  part  of  the  prisoner  to  show 
that  the  wound  had  been  accidentally  occasioned  by  the 
deceased  falling,  while  drunk,  downward  upon  the  knife 
which  the  prisoner  had  held  in  his  hand  sloping  upward, 
the  direction  of  the  wound  would  prove  the  falsity  of  the 
statement.  Two  other  cases  are  here  quoted  from  Wharton 
and  Stille's  Med.  Jurisp.,  of  a  similar  character.  One  of  a 
man  discovered  dead,  with  a  deeply-punctured  wound  of 
the  neck,  which,  on  examination,  showed  that  the  weapon 
had  been  partially  turned  and  withdrawn,  and  again  plunged 
into  the  neck  in  a  different  direction,  after  the  manner  of 
the  German  butchers.  This  circumstance  proved  not  only 
that  the  death  was  not  accidental,  nor  probably  suicidal, 
but  indicated  the  occupation  of  the  murderer.  The  other 
occurred  in  England,  some  years  since,  where  a  murder 
was  fixed  upon  a  man  from  the  fact  that  the  wound  in  the 
neck  of  the  deceased  had  been  evidently  made  by  a  knife 
cutting  from  within  outward,  as  is  done  in  slaughtering 
sheep. 

In  most  suicidal,  wounds  of  the  throat,  it  is  found  that  the 
cut  has  been  made  from  left  to  right ;  in  punctured  wounds 
the  direction  is  commonly  from  right  to  left,  and  downward. 
In  left-handed  persons,  the  direction  would,  of  course,  be 
the  reverse.  These  facts,  however,  can  only  afford  moderate 
presumptive  evidence,  since  it  is  obvious  that  a  murderer 
might  inflict  an  incised  wound  in  the  throat  of  his  victim 
from  behind,  which  would  exactly  resemble  that  made  by 
the  suicide.  In  all  such  doubtful  cases,  particular  attention 
should  be  directed  to  the  surrounding  circumstances,  such 
as  the  position  of  the  body,  and  the  weapon,  the  presence 


106  MEDICAL   JURISPRUDENCE. 

or  absence  of  blood  upon  the  hands  and  person  of  the 
deceased,  etc.  If  the  death  has  been  very  sudden,  from 
hemorrhage  (in  a  case  of  suicide),  the  weapon  will  most 
probably  have  fallen  from  the  hand,  on  account  of  the 
relaxation  of  the  muscles ;  but  if  it  has  been  caused  by  a 
pistol,  the  weapon  may  be  found  tightly  grasped  in  the 
hand  of  the  deceased.  If  the  throat  has  been  cut  suicidally, 
blood  will  be  found  on  one  or  other  of  the  hands;  but  if 
homicidally,  and  no  resistance  has  been  made,  the  hands 
will  probably  be  unstained.  As  regards  the  position  of  the 
body,  if  the  death  be  very  sudden,  from  loss  of  blood,  the 
body  will  be  found  lying  on  the  back ;  if  less  sudden,  the 
face  and  trunk  will  be  turned  toward  the  ground.  If  the 
body  be  found  upon  the  back,  in  death  from  hemorrhage, 
and  the  weapon  at  a  distance  from  it,  the  act  was,  in  all 
probability,  homicidal. 

The  position  of  the  zucapon  in  relation  to  the  dead  body, 
although  at  times  strongly  suggestive,  can  never  afford 
absolute  evidence  as  regards  the  question  of  homicide  or 
suicide.  Thus,  Professor  Casper  mentions  the  case  of  a 
man  who  cut  his  throat  with  a  razor,  which  was  found, 
bloody,  and  closed,  two  feet  distant  from  the  body.  Also,  of 
another  suicide  by  a  pistol-shot  in  the  breast,  where  the 
pistol  was  found  in  the  pocket  of  the  deceased,  who  after-* 
wards  terminated  his  life  by  drowning  himself  {Gerielit. 
p.  17). 

From  what  has  been  said  above,  it  is  manifest  that  the 
medical  jurist  can  rarely  venture  to  give  a  positive  opinion 
as  to  the  homicidal,  suicidal,  or  accidental  cause  of  death, 
apart  from  a  consideration  of  the  circumstances  accompany- 
ing it.  These  circumstances  constantly  vary  in  almost  every 
case,  and  they  require  the  utmost  experience  and  tact  on 
the  part  of  the  medical  examiner  to  recognize  and  apply 


GUNSHOT    WOUNDS.  107 

them  in  each  individual  instance.  Some  of  them  have 
already  been  alluded  to :  they  include  the  position  of  the 
body  and  the  weapon;  the  condition  of  the  ground  where 
the  wound  was  inflicted ;  the  presence  of  footprints,  of  man 
or  horse;  the  condition  of  the  clothing  of  the  deceased;  the 
condition  of  the  hands,  whether  showing  wounds,  or  cuts  on 
their  palms  (indicating  resistance),  or  the  hands  holding 
portions  of  hair  or  fragments  of  the  assailant's  clothes;  the 
adherence  of  certain  fibres  to  a  weapon,  such  as  cotton, 
woolen,  linen,  silk  or  fur ;  marks  of  blood  upon  clothing  or 
furniture ;  state  of  the  mouth  and  throat ;  marks  of  blood 
or  other  matters  on  the  person  of  the  assailant ;  rifling  of 
the  pockets,  and  tearing  of  the  dress,  etc.  These  cannot  be 
farther  enlarged  upon  here,  but  their  medico-legal  import- 
ance cannot  be  too  strongly  insisted  upon. 

SECTION  II. 

GUNSHOT  WOUNDS. 

DIFFER  FROM  OTHER  WOUNDS. — DEFLECTION  OF  THE  BALL. — WOUNDS 
MADE  BY  SHOT,  WADDING  AND  POWDER. — CAUSE  OF  DEATH  IN 
WOUNDS. — WOUNDS   OF  THE   HEAD,  NECK,  SPINE,  CHEST,  ABDOMEN. 

Gunshot  wounds  differ  from  other  wounds  chiefly  in  the 
fact  that  the  vitality  of  the  part  struck  is  lost,  and  that  there 
is  a  consequent  slough,  or  loss  of  substance.  They  are 
essentially  contusions.  They  are  dangerous  to  life  on  ac- 
count of  their  involving  vital  portions  of  the  body,  death 
occurring  either  from  hemorrhage,  or  from  shock  to  the 
nervous  system.  The  hemorrhage  is  seldom  great,  except 
when  large  vessels  are  wounded.  Often,  from  the  form  of 
the  wound,  there  may  be  but  little  external  bleeding,  while 
a  fatal  internal  hemorrhage  may  be  going  on.  They  differ 
much  in  appearance,  according  to  the  distance  from  which 
the  piece  was  fired,  and  the  nature  of  the  projectiles.     If  the 


108  MEDICAL   JURISPRUDENCE. 

explosion  occurs  in  close  contact  with  the  body,  the  wound 
is  large  and  circular,  the  skin  denuded,  blackened  and 
burned  by  the  half  consumed  grains  of  powder.  The  hair 
and  clothes  also  in  the  vicinity  of  the  wound  are  more  or 
less  scorched.  The  entrance  orifice  of  the  ball  is  livid  and 
depressed,  and  is  larger  than  the  point  of  exit  When  the 
piece  is  fired  from  a  distance,  the  blackened  and  burned  ap- 
pearance of  the  skin  is  not  seen,  but  only  the  mark  of  the 
entrance  of  the  missile,  and  sometimes  that  of  the  exit. 
The  aperture  of  entrance  of  the  ball  when  fired  from  a 
distance  is,  according  to  most  authorities,  always  smaller 
than  that  of  exit.  Nelaton  says  that  when  the  wound  is 
recent,  the  entrance  orifice  is  depressed  and  contused,  while 
the  exit  aperture  is  lacerated  and  everted.  In  the  former, 
there  is  an  actual  loss  of  substance;  in  the  latter,  there  is 
merely  a  solution  of  continuity.  After  some  days,  however, 
the  contused  margins  of  the  entrance  wound  slough  away, 
thereby  enlarging  the  orifice,  while  those  of  the  exit  par- 
tially adhere,  causing  the  latter  wound  to  appear  smaller 
than  the  former.  Professor  Casper  declares  that  the  en- 
trance aperture  is  always  the  larger.  Very  possibly,  this 
discrepancy  of  views  may  arise  from  not  distinguishing  be- 
tween the  early  and  the  later  stages  of  the  two  orifices.  If 
the  ball  enters  a  very  fat  portion  of  the  body,  this  often 
protrudes  between  the  edges  of  the  wound,  and  completely 
changes  its  appearance.  Again,  the  character  of  the  en- 
trance will  depend  very  much  upon  the  nature  of  the  pro- 
jectile, and  its  velocity,  as  well  as  the  distance  from  which 
it  was  fired.  If  the  ball  is  conoidal,  as  in  the  minie  rifle, 
and  traveling  with  great  speed,  the  wound  is  linear,  and 
resembles  a  puncture,  producing  little  external  harm,  but 
causing  very  considerable  internal  injury.  A  rifle  ball 
makes   a   large   and   ragged   wound,   caused  by  the   spiral 


WOUNDS    BY    SHOT.  109 

direction  given  to  the  missile.  It  is  evident  that  several 
wounds  may  be  made  by  a  single  ball,  as  this  may  chance 
to  traverse  different  parts  of  the  body  and  limbs.  It  may 
also  happen  that  the  piece  may  have  been  loaded  with  two 
or  more  balls,  which  may  account  for  the  number  of  the 
wounds. 

The  deflection  of  a  ball  from  its  straight,  or  direct  course 
after  entering  the  body  is  easily  produced  by  its  striking 
obliquely  against  any  resisting  surface,  such  as  a  bone, 
tendon,  aponeurosis,  or  even  muscle.  In  this  way  it  often 
happens  that  a  ball,  striking  the  chest  or  abdomen,  may  be 
caused  to  pass  almost  entirely  around  the  body,  and  after- 
wards be  extracted  close  by  the  entrance  point.  Wharton 
and  Stille  (Med.  Jio-isp)  relate  the  case  of  a  German  student 
who  was  wounded  in  a  duel  by  a  pistol  ball  striking  him  on 
the  larynx  obliquely,  and  passing  around  the  neck  so  as  to 
lodge  on  the  opposite  side  of  the  thyroid  cartilage.  It  was 
thence  removed  by  simply  cutting  through  the  skin.  It  is 
not  uncommon  for  a  ball  to  travel  half  way  around  the  chest 
or  abdomen,  and  lodge  in  the  back,  giving  the  appearance  of 
having  passed  directly  through  the  lungs,  or  intestines. 

If  the  wound  be  caused  by  a  load  of  shot,  its  appearance  will 
depend  chiefly  on  the  distance  from  which  it  was  discharged. 
If  fired  very  near  the  body,  so  as  to  enter  it  as  a  single 
charge  before  separating,  it  will  produce  a  single  large 
and  ragged  wound,  much  contused  and  blackened  by  the 
powder ;  and  as  the  shot  diverge  after  entering  the  body, 
there  will  be  considerable  laceration  of  the  parts  beneath. 
For  the  opening  to  be  single,  the  experiments  of  Dr. 
Lachese,  of  Antwerp,  have  shown  that  the  charge  should 
not  be  fired  at  a  greater  distance  than  ten  to  twelve  inches. 
When  the  distance  is  so  extended  as  to  allow  the  scattering 
of  the  shot,  each  grain  will  make  its  own  individual  wound. 


110  MEDICAL   JURISPRUDENCE. 

It  is  quite  possible  for  a  single  shot  to  cause  a  mortal  wound, 
as  when  it  happens  to  strike  the  heart,  or  aorta. 

Wounds  made  by  the  wadding  and  gunpowder  alone  may 
prove  serious  or  fatal,  according  to  the  distance  of  the  piece 
from  the  body.  A  pistol  thus  loaded,  at  twelve  inches 
distance  tore  the  clothes,  and  abraded  the  skin  without 
penetrating  it ;  at  half  this  distance,  the  wadding  penetrated 
to  the  depth  of  half  an  inch ;  at  two  inches  it  entered  to 
the  depth  of  two  inches,  causing  a  ragged  and  blackened 
wound ;  and  at  one  and  a  half  inches,  the  wadding  entered 
the  thorax  between  the  ribs,  and  in  one  experiment,  carried 
away  a  portion  of  the  rib  {Phil.  Med.  Exam.,  1846).  Taylor 
mentions  an  instance  of  a  man  sitting  in  a  gallery  of  a 
theatre  at  Brighton,  in  1SS1,  who  had  the  upper  half  of  his 
hand  completely  blown  away  by  a  piece  of  greased  news- 
paper, tightly  rammed,  discharged  from  a  small  cannon  on 
the  stage  of  the  theatre. 

Even  gunpowder  alone  is  capable  of  producing  very 
serious  wounds,  if  fired  close  to  an  exposed  part  of  the 
body.  The  wound  will  present  a  lacerated  appearance,  and 
be  blackened  and  burned  by  the  partially  consumed  powder. 
If  the  grains  of  powder  be  coarse,  the  wound  may  have  the 
appearance  of  having  been  caused  by  very  small  shot. 

The  question  of  the  homicidal,  suicidal,  or  accidental  char- 
acter of  gunshot  wounds  must  generally  be  settled  by  the 
appearance  of  the  wounds,  and  also  by  the  surrounding 
circumstances.  Thus,  if  it  be  on  the  forehead  or  temple,  in 
the  mouth  or  over  the  heart,  and  if  it  be  blackened  and 
lacerated  (indicating  the  close  proximity  of  the  weapon),  it 
may  be  regarded  as  a  suicidal  act.  If,  on  the  contrary,  the 
wound  be  on  the  back,  or  side  of  the  head  (except  in  the 


CAUSE    OF    DEATH    FROM    WOUNDS.  Ill 

case  of  the  insane),  or  of  the  body,  without  the  blackened 
and  lacerated  appearance  above  alluded  to,  it  may  be  con- 
sidered as  the  act  of  a  homicide.  Accidental  gunshot 
wounds  bear  the  marks  of  near  wounds,  as  they  are  mostly 
the  result  of  the  accidental  discharge  of  the  piece,  either  in 
the  hands  of  the  deceased  at  the  time,  or  else  in  close  prox- 
imity to  his  person. 

Out  of  368  cases  of  suicide  by  firearms,  297  were  from 
wounds  in  the  head;  of  these,  234  were  fired  into  the  mouth; 
only  71  were  from  wounds  inflicted  on  the  chest  or  abdo- 
men (M.  de  Boismont,  Du  Suicide,  p.  531). 

Cause  of  Death  from  Wounds. — In  a  medico-legal 
case  it  may  become  important  to  ascertain  the  real  cause  of 
death  occasioned  by  a  wound — whether  immediate,  as  from 
hemorrhage  or  shock,  or  remote \  resulting  from  subsequent 
complications.  In  a  trial  for  murder,  this  question  might 
have  an  important  bearing  on  the  result. 

When  the  death  is  directly  traceable  to  hemorrhage,  its 
rapidity  depends  upon  the  amount  and  suddenness  of  thi 
bleeding;  and  this  again  is  dependent  on  the  size  and 
nature  of  the  vessel  wounded.  Exhaustion  follows  much 
more  rapidly  from  a  sudden  hemorrhage  than  from  a  more 
copious  flow  of  blood  if  gradually  lost.  Again,  arterial 
hemorrhage  is  more  rapidly  fatal  than  venous.  It  should 
also  be  remembered  that  some  persons  have  a  constitutional 
tendency  to  bleed  very  easily,  from  the  slightest  superficial 
wound.  Such  a  tendency  is  termed  a  hemorrhagic  diathesis; 
this  is  sometimes  hereditary;  and  where  it  exists,  it  exposes 
the  individual  to  great  danger,  in  case  of  being  wounded. 
Age  and  disease  also  increase  the  danger  of  death  by  hem- 
orrhage from  wounds. 

Internal  hemorrhage,  as  the  result  of  a  wound,  is  often  as 


1  12  MEDICAL   JURISPRUDI 

fatal  as  the  external ;  the  danger  is  here  further  increased 
by  the  pressure  exerted  by  the  effused  blood  upon  a  vital 
organ,  such  as  the  brain,  as  is  witnessed  in  effusion  of  blood 
within  the  cranium,  produced  by  a  fracture  of  the  skull. 
It  is  also  exemplified  in  a  wound  of  the  intercostal  arteries, 
causing  effusion  of  blood  into  the  chest,  and  producing  fatal 
pressure  on  the  lungs ;  and  also  in  wounds  of  the  throat 
resulting  in  asphyxia,  from  the  flow  of  the  blood  into  the 
windpipe. 

Shock  is  the  result  of  a  violent  impression  made  on  the 
great  nervous  centres.  It  often  is  the  immediate  cause  of 
death,  after  a  severe  injury,  without  leaving  behind  any 
trace  or  lesion  discoverable  on  a  post-mortem  examination. 
Shock  is  most  apt  to  follow  extensive  lacerations  of  the 
body,  such  as  result  from  machinery  or  railway  accidents, 
or  from  extensive  burns. 

The  remote  causes  of  death  from  wounds  are  numerous 
and  varied.  The  following  may  be  regarded  as  the  most 
common : — 

1.  Tetanus  or  lockjaw. — This  is  generally  the  result  of 
lacerated  and  punctured  wounds,  and  especially  if  inflicted 
on  nerves,  tendons,  aponeuroses  and  fibrous  tissues.  A  very 
slight  wound  in  these  structures  may  be  followed  by  fatal 
tetanus.  Tetanus  is  always  a  very  serious  complication, 
and  is  mostly  fatal.  It  does  not  usually  appear  before  the 
seventh  day  after  the  receipt  of  the  wound,  though  some- 
times earlier ;  and  it  rarely  supervenes  after  the  twentieth 
day. 

2.  Erysipelas  is  another  complication  of  wounds,  which 
may  give  to  them  a  fatal  issue.  It  is  particularly  apt  to 
accompany  wounds  of  the  scalp ;  and  it  sometimes  assumes 
an  epidemic  character,  especially  in  hospitals,  where  it  may 
occasion  great  mortality  among  the  wounded  patients. 


DEATH  FROM  SURGICAL  INTERFERENCE.        113 

3.  Hospital  gangrene  is  another  occasional  result  of 
wounds.  It  likewise  often  proves  fatal,  and  may  assume  an 
epidemic  type.  It  is,  however,  rarely  seen,  except  in  mili- 
tary hospitals,  and  seems  to  be  connected  with  faulty 
hygienic  arrangements. 

4.  Surgical  interference,  including  the  Use  of  Ancesthetics. — 
In  wounds  dangerous  to  life,  the  question  of  the  propriety 
of  a  surgical  operation  becomes  paramount;  the  patient  will 
certainly  die  without  the  operation,  and,  on  the  other  hand, 
he  may  die  from  shock,  as  the  immediate  result  of  the 
operation.  The  question  of  the  legal  responsibility  of  the 
death  then  becomes  a  serious  one,  and  in  the  event  of  a 
trial,  the  counsel  for  the  prisoner,  who  had  originally  in- 
flicted the  wound,  will  endeavor  to  show  that  the  death  was 
not  really  the  result  of  the  wound,  but  was  rather  owing  to 
the  surgical  operation.  Whatever  plausibility  there  may  be 
in  such  an  argument,  it  would  not  likely  avail  with  an  intel- 
ligent court  and  jury,  unless  it  could  be  proved  that  the 
original  wound  was  not  of  a  dangerous  character ;  and, 
secondly,  that  the  surgical  interference  was  unwarrantable, 
and  unskillfully  employed.  The  same  remarks  will  apply 
to  the  use  of  anaesthetics  (ether  and  chloroform)  in  the  per- 
formance of  surgical  operations.  Their  employment  in  such 
cases  has  now  become  so  universal  throughout  the  civilized 
world, that  the  occasional  fatal  results  attending  their  admin- 
istration should  be  regarded  as  exceptions  to  the  universal 
rule  of  safety  accompanying  their  employment,  and  as  in  no 
wise  inculpating  the  attending  surgeon  ;  consequently,  the 
fatal  result  that  might  happen  to  follow  their  use  should  not 
be  considered  as  offering  any  extenuation  for  the  prisoner,  if 
the  latter  has  inflicted  a  dangerous  or  fatal  wound  upon  the 
deceased.  The  only  medico-legal  point  at  issue  would  be — 
was  the  administration  of  the  anaesthetic  a  necessary  and 

6* 


114  MEDICAL   JURISPRUDENCE. 

proper  part  of  the  treatment,  and  was  it  skillfully  adminis- 
tered ? 

It  will  be  proper  to  devote  a  brief  consideration  to  the 
subject  of  Wounds  in  different  regions  of  the  body,  inasmuch 
as  these  present  certain  individual  peculiarities,  which  give 
to  them  special  medico-legal  importance. 

Wounds  of  the  head. — Scalp  wounds  are  not  usually  at- 
tended with  danger,  except  sometimes,  when  followed  by 
erysipelas,  and  when  the  blow  has  been  so  severe  as  to 
produce  concussion  of  the  brain.  It  must  not  be  forgotten 
that  fracture  of  the  skull  may  exist  without  any  wound  of 
the  scalp ;  also  that  fatal  effusion  of  blood  upon  the  brain 
may  be  produced  by  a  blow  on  the  head,  without  causing 
either  a  wound  of  the  scalp,  or  a  fracture  of  the  skull. 

Concussion  of  the  brain  may  result  either  from  a  direct 
blow  upon  the  head,  or  from  a  violent  fall  upon  the  feet 
or  buttocks.  Sometimes  death  ensues  immediately  from 
concussion,  leaving  behind  it  no  perceptible  lesion,  though, 
doubtless,  some  molecular  change  has  been  caused  in  the 
nerve  cells,  not  recognizable  by  the  microscope.  Such  fatal 
concussion  may  occur  without  either  fracture  of  the  skull, 
or  even  a  wound  of  the  scalp.  The  symptoms  of  concussion 
are  faintness,  nausea  and  vomiting,  pallor  of  face,  feeble 
pulse,  loss  of  consciousness,  either  partial  or  complete,  with 
subsequent  confusion  of  ideas,  and  tendency  to  sleep.  Con- 
cussion may  be  confounded  with  intoxication,  compression 
of  the  brain,  opium  poisoning,  sunstroke,  etc. 

It  is  particularly  important,  for  medico-legal  reasons,  to 
distinguish  between  concussion  and  intoxication.  Doubtless, 
many  cases  of  supposed  drunkards,  arrested  in  large  cities  at 
night  by  the  police,  and  left  unattended  in  the  station  house  till 
morning,  are,  in  reality,  cases  of  concussion,  or  compression 
of  the   brain,  which   may  prove   fatal,  simply   for   want   of 


COMPRESSION  OF  THE  BRAIN.  1  1  5 

timely  relief.  What  adds  greatly  to  the  difficulty  of  the 
diagnosis  is  the  fact  that  the  two  conditions  are  so  frequently 
coincident  in  the  same  individual.  It  is  the  drunken  man 
who  is  most  apt  to  engage  in  a  brawl  which  results  in  a 
broken  head.  Generally,  the  history  of  the  case  (if  it  can 
be  obtained),  and  the  odor  of  the  breath,  will  afford  us  the 
best  means  of  diagnosis.  In  intoxication,  the  temperature 
is  usually  below  960  F. — sometimes  below  900  ;  the  loss  of 
power  and  of  sensation  are  not  unilateral,  as  in  compression  ; 
the  bladder  is  generally  full  of  limpid  urine,  which  will 
furnish  evidence  of  the  presence  of  alcohol  on  distillation. 
( Via1.  Alcohol, /wA)  The  pupils  are  sometimes  contracted, 
and  again  dilated. 

Fracture  of  the  skull  is  the  result  either  of  a  direct  blow 
upon  the  head,  or  of  a  fall  upon  the  head,  striking  a  stone, 
or  other  hard  body.  The  usual  consequence  of  such  a 
fracture  is  pressure  on  the  brain  by  the  depressed  bone,  or 
by  the  extravasated  blood  from  a  ruptured  vessel,  or  vessels. 
Fracture  of  the  base  of  the  skull is  the  most  dangerous  of  all. 
It  is  nearly  always  fatal ;  and  unless  carefully  looked  for  in 
the  autopsy,  it  may  entirely  escape  notice. 

Compression  of  the  brain  may  result  either  from  effusion 
of  blood  or  serum  upon,  or  within  the  brain,  with  or  without 
fracture,  or  depression  of  the  bone;  also  from  suppuration, 
or  tumors  in  the  brain,  from  congestion  of  the  cerebral 
vessels,  and  likewise  from  narcotic  poisoning.  The  symp- 
toms are  essentially  those  of  apoplexy,  viz.:  loss  of  con- 
sciousness, paralysis  (usually  hemiplegia),  dilated  pupils 
(except  where  the  effusion  is  on  the  pons  Varolii,  when, 
according  to  Dr.  Wilks,  the  pupils  are  contracted),  stertor- 
ous breathing,  a  full,  slow  pulse,  and  coma.  It  is  important 
to  remember  that  the  effusion  of  blood  resulting  from  a 
blow  may  be  very  gradual,  so  that  the  person  seemingly 


116  MEDICAL    JURISI'RUDEN'CE. 

recovers  from  the  first  shock,  and  may  be  able  even  to 
resume  his  ordinary  occupation  for  some  hours,  or  even 
days,  before  the  fatal  termination  takes  place.  The  distinc- 
tion between  the  effusion  from  violence,  and  that  resulting 
from  disease,  as  a  rule,  is  that  in  the  former  the  extravasa- 
tion is  nearly  always  between  the  skull  and  dura  mater,  or 
between  this  membrane  and  the  brain,  while  in  the  latter  it 
is  usually  in  the  brain  substance.  Moreover,  in  the  first, 
there  is  frequently  a  fracture  of  the  bone,  and  ecchymosis 
of  the  scalp,  either  immediately  over  the  effusion  or  on  the 
opposite  side  of  the  head  (contre  coup). 

Another  important  medico-legal  point  is,  that  a  fatal  effu- 
sion of  blood  may  take  place  simply  from  great  excitement, 
in  a  quarrel,  especially  if  accompanied  by  intoxication. 
In  a  trial  for  homicide  this  is  likely  to  be  urged  by  the 
defence  as  the  probable  cause  of  death  in  the  deceased, 
where  there  has  been  an  assault  or  pugilistic  encounter, 
which  terminates  fatally.  In  a  case  of  this  nature  it  might 
be  extremely  difficult  to  decide  how  far  the  fatal  effusion 
was  due  to  natural  causes,  such  as  atheroma  of  the  cerebral 
arteries  (which,  in  an  habitual  spirit-drinker,  might  also  be 
connected  with  a  diseased  liver  and  kidneys),  or  how  far  it 
was  to  be  attributable  to  the  effects  of  violence.  We  are, 
however,  of  the  opinion  that,  if  the  assault  could  be  clearly 
proven,  either  in  connection  with  a  direct  blow  upon  the 
head,  or  indirectly,  by  a  fall  upon  a  stone  or  other  hard 
body,  the  mere  fact  of  the  preexisting  disease  of  the  arteries, 
or  the  other  organs,  would  not  exculpate  the  prisoner,  nor 
acquit  him  of  the  charge  of  homicide.  If,  however,  the 
autopsy  shows  that  the  effused  clot,  or  serum,  were  of  older 
date  than  the  alleged  injury,  this  would  certainly  be  a  strong 
argument  for  his  acquittal. 

Wounds  of  the  Substance  of  the  Brain  are  not  always  fatal. 


WOUNDS    OF    THE    SPINE.  117 

As  regards  the  symptoms  of  injury  to  the  different  portions  of 
this  organ,  as  indicating  the  localization  of  its  various  func- 
tions, the  reader  must  be  referred  to  the  writers  on  this 
special  department  of  science.  It  is  well  known  that  con- 
siderable portions  of  the  cerebral  substance  have  escaped 
through  the  skull,  after  fractures,  not  only  without  loss  of 
life,  but  without  any  sensible  impairment  of  the  mental 
powers. 

Wounds  of  the  Face  are  not  usually  dangerous  unless  they 
involve  the  orbit ;  a  penetrating  wound  of  this  part  may 
readily  reach  the  brain,  with  a  fatal  result.  So  also,  a 
severe  blow  upon  the  nose  may  so  injure  the  ethmoid  bone 
as  subsequently  to  involve  the  brain. 

Wounds  of  the  Neck  are  attended  with  much  danger, 
owing  to  the  presence  of  the  large  vessels  and  nerves.  In 
cut  throats,  the  great  danger  arises  from  the  sudden  and 
profuse  hemorrhage.  The  section  of  the  larynx  and  trachea 
is  not  necessarily  fatal,  the  chief  danger  arising  from  suffo- 
cation from  the  flowing  back  of  the  blood.  A  division  of 
the  oesophagus  is  almost  necessarily  fatal,  chiefly  because  of 
its  involving  the  section  of  the  great  vessels  of  the  neck. 

Wounds  of  the  Spine  are  dangerous  in  proportion  to  the 
degree  that  the  spinal  marrow  is  involved.  In  concussion 
of  the  spine,  death  sometimes  takes  place  instantly.  If  the 
spinal  cord  be  wounded  high  up,  above  the  region  of  the 
phrenic  nerve,  the  function  of  respiration  is  immediately 
arrested,  and  death  ensues.  Wherever  the  injury  occurs  to 
the  spinal  cord,  it  is  understood  that  there  is  a  complete 
suspension  of  the  functions  of  the  parts  below.  In  fracture 
of  the  vertebra?,  the  great  danger  arises  from  pressure  on  the 
spinal  marrow.  Sudden  death  has  been  produced  by  the 
spontaneous  luxation  of  the  second  cervical  vertebra,  aris- 
ing from  the  fracture  of  the  odontoid  process,  through  dis- 


118  MEDICAL   JURISPRUDENCE. 

ease.  Sir  A.  Cooper's  case  was  of  this  character  (Frac.  and 
Disloc.  p.  463).  These  fractures  are  justly  considered  as 
having  an  important  medico-legal  bearing. 

Wounds  of  the  Chest. — The  great  danger  here  lies  in  the 
hemorrhage  from  the  heart,  great  vessels  and  lungs  ;  hence, 
such  wounds  often  prove  rapidly  fatal.  The  hemorrhage  in 
wounds  of  the  chest  is  nearly  always  internal.  Wounds  of 
the  lungs,  though  they  may  not  prove  immediately  fatal, 
frequently  so  terminate  after  a  lapse  of  time ;  this  is  especially 
true  of  gunshot  wounds,  if  the  bullet  or  other  foreign  sub- 
stance happens  to  be  retained.  Wounds  of  the  Heart  nearly 
always  terminate  fatally  and  rapidly,  if  the  cavities  be  pene- 
trated. Gunshot  wounds  of  the  heart  do  not  necessarily 
cause  immediate  death ;  cases  are  recorded  where  the 
patient  survived  several  months ;  after  death  the  ball  has 
been  found  in  the  substance  of  the  organ.  Even  where  the 
cavities  of  the  heart  have  been  perforated  by  a  cutting 
instrument,  there  have  been  instances  where  the  person  sur- 
vived for  eleven  days  (Wharton  and  Stille,  Med.  Jurisp.  p. 
745  ).  Rupture  of  the  heart  may  be  the  result  of  a  violent 
blow  upon  the  thorax,  or  it  may  follow  any  intense  excite- 
ment or  emotion,  if  this  organ  happens  to  be  in  a  diseased 
condition,  as  in  fatty  degeneration,  etc.  In  a  medico-legal 
case,  where  death  has  resulted  from  this  cause  in  a  brawl, 
in  which  the  deceased  received  a  severe  blow  on  the  chest, 
if  the  pre-existing  disease  of  the  organ  can  be  established, 
it  would  be  a  question  how  far  the  violence,  and  how  for  the 
disease  was  to  be  credited  with  the  result.  The  case  is  very 
similar  to  the  one  where  death  follows  a  blow  upon  the  head, 
terminating  in  compression  of  the  brain,  and  where  a  dis- 
I  condition  of  the  cerebral  vessels  existed. 

Wounds  of  the  Abdonien. — Even  a  superficial  wound  of 
the  abdomen   may  prove   fatal,  by  dividing   the  epigastric 


WOUNDS   OF   THE    GENITAL   ORGANS.  119 

artery.  A  severe  blow  upon  the  epigastric  region  has  fre- 
quently produced  immediate  death,  from  shock  upon  the 
solar  plexus  of  nerves.  Blows  upon  any  part  of  the  abdo- 
men may  be  followed  by  peritoneal  inflammation,  which 
often  proves  fatal.  Penetrating  wounds  may  terminate 
fatally  from  the  same  cause.  Wounds  of  the  stomach  and 
intestines  are  e'xceedingly  dangerous,  and  are  often  mortal, 
either  from  hemorrhage,  or  from  inflammation,  or  both. 

Wounds  of  the  Liver  are  dangerous,  according  to  their 
extent  and  depth.  If  the  gall-bladder  is  involved,  death  is 
apt  to  ensue,  in  consequence  of  the  peritonitis.  The  danger 
from  wounds  of  the  kidneys  arises  from  the  effusion  of  urine, 
and  the  consequent  inflammation. 

In  relation  to  wounds  of  the  bladder,  it  should  be  remem- 
bered that  this  organ  may  be  ruptured  spontaneously,  from 
over-distention.  It  is  sometimes  ruptured  by  a  blow,  or 
kick  of  a  horse,  upon  the  lower  part  of  the  abdomen.  In 
a  trial  for  homicide,  in  a  case  of  death  produced  by  rupture 
of  the  bladder,  the  defence  would  probably  try  to  set  up  the 
plea  of  spontaneous  rupture  of  this  organ.  Frequently, 
there  is  no  external  injury  to  indicate  the  true  nature  of  the 
case,  the  autopsy  alone  revealing  it,  and  disclosing,  also, 
extensive  peritoneal  inflammation,  resulting  from  the  escape 
of  urine. 

Wounds  of  the  Genital  Organs  are,  in  the  male,  usually 
self-inflicted,  and  they  are  met  with  most  generally  among 
the  insane.  They  comprise  castration — more  or  less  com- 
plete, and  amputation  of  the  penis — partial  or  entire.  The 
danger  to  life  is  great  in  proportion  to  the  hemorrhage,  and 
injury  to  the  organs.  In  certain  other  cases,  where  the  in- 
jury has  been  inflicted  by  others,  and  when  in  a  state  of  erec- 
tion, the  urethra  has  been  found  violently  torn   across,  and 


120  MEDICAL    JURISPRUDENCE. 

the  corpora  cavernosa  and  spongiosa  divided.  In  females, 
the  chief  point  of  medico-legal  interest  is  to  discriminate 
between  wounds  of  the  genitals  inflicted  by  another,  and 
spontaneous  hemorrhages  from  a  ruptured  vein  in  the  labia. 
Here,  of  course,  a  rigid  inspection  of  the  injured  parts  will 
be  required  before  arriving  at  a  definite  conclusion. 


EXAMINATION    OF    BLOOD-STAINS.  1-1 


CHAPTER  VII. 

EXAMINATION  OF  BLOOD  STAINS. 

IMPORTANCE  OF  THEIR  IDENTIFICATION. — THREE  METHODS  OF  IDENTI- 
FICATION.—  I.  THE  CHEMICAL  TESTS. — 2.  THE  MICROSCOPIC  TEST. — 
3.    THE  SPECTROSCOPIC   TEST. — BLOOD-CRYSTAES. 

The  identification  of  blood-stains  not  infrequently  con- 
stitutes a  most  important  link  in  the  chain  of  evidence,  in  a 
trial  for  homicide.  It  is  a  very  common  practice  for  a 
murderer  to  attribute  certain  suspicious  red  stains  dis- 
covered upon  his  garments,  or  implements,  to  the  blood 
of  some  domestic  animal  or  bird.  Within  a  few  years  past 
the  resources  of  science  have  afforded  us  material  aid  in 
distinguishing  human  blood-stains  from  those  of  the  inferior 
animals,  so  that  the  legal  physician  may  now  feel  much 
more  confident  in  delivering  his  testimony  in  a  trial  for 
homicide,  than  he  could  have  done  in  former  years. 

The  appearance  of  blood-stains  to  the  naked  eye  will  vary 
in  size,  shape  and  color.  Sometimes  it  may  be  a  mere  film 
or  smear,  but  generally  it  presents  the  form  of  distinct  spots 
of  different  sizes;  and  if  the  blood  has  spurted  obliquely 
upon  a  surface,  the  spots  will  have  assumed  a  comet-like 
shape,  terminating  in  a  bulbous  tail.  The  color  of  the  stain 
will  depend  (1)  upon  its  freshness:  if  recent,  it  will  have  a 
bright  red  hue  ;  if  old,  the  color  will  be  brownish,  or  brown- 
red.  (2)  Upon  its  thickness ;  being  darker  in  proportion  to 
the  density  of  the  stain.  (3)  Upon  the  material  on  which  it 
has  fallen;  if  the  latter  is  porous,  as  soft  wood,  or  linen  or 
cotton  fabrics,  the  tint  will  be  rather  dull,  but  if  on  polished 
and  hard  substances,  such  as  metals  or  polished  wood,  the 


122  MEDICAL   JURISPRUDENCE. 

spots  have  a  darker  and  shining  appearance,  and  on  drying 
they  are  apt  to  crack  from  the  centre,  and  may  thus  easily 
be  removed.  When  dried  upon  linen  or  cotton,  they  usually 
have  a  stiffened  feel,  like  a  spot  of  dried  albumen  or  gum. 
If  the  stains  be  upon  a  colored  substance,  they  can  best  be 
distinguished  by  artificial  light;  indeed,  they  may  be  en- 
tirely invisible  in  bright  daylight. 

We  possess  three  methods  of  identifying  blood  stains  : 
(i)  the  chemical;  (2)  the  microscopic;  (3)  the  spectro- 
scopic or  optical.  But  previously  to  employing  these 
methods,  it  will  be  always  proper  to  examine  the  sus- 
pected spot  with  a  good  magnifier;  the  spot,  if  a  blood  stain, 
will  frequently  exhibit  minute  coagula  or  clots  of  a  shiny 
hue,  intermixed  with  the  fibres  of  the  material  on  which  it 
is  fixed. 

I.  The  Chemical  Tests. — Before  noticing  these,  it  will  be 
proper  to  remark  briefly  on  the  solubility  of  the  coloring 
matter  of  blood.  Modern  research  has  shown  that  the 
coloring  matter  of  blood,  when  quite  recent  {hemoglobin  or 
oxy-hczmoglobin),  is  very  soluble  in  cold  water,  but  when 
old,  so  as  to  have  changed  to  a  brown  color,  it  is  converted 
into  hecmatin,  or  deoxidized  hemoglobin,  which  is  insoluble  in 
water.  This  is  a  fact  of  considerable  medico-legal  interest. 
For  if  a  garment,  or  other  article  stained  with  blood,  is 
immediately  washed  in  cold  water,  the  whole  of  the  blood 
will  probably  be  discharged,  so  as  to  leave  no  trace  of  it 
behind.  But  if  (as  is  usually  the  case)  the  garment  be 
kept  for  some  time  before  the  attempt  is  made  to  remove 
the  stain  by  washing,  the  soluble  hemoglobin  will  have 
become  more  or  less  connected  with  the  insoluble  hematin, 
and  enough  of  the  blood  will  remain  upon  the  article  to 
suffice  for  future  identification.     Hot  water  will  not  remove 


Los  Annies,  OaL 

CHEMICAL    TESTS    FOR    BLOOD.  L23 

a  recent  blood  stain  as  effectually  as  cold  water,  on  account 
of  the  action  of  the  heat  upon  the  haemoglobin. 

If  the  blood-spot  be  recent,  the  examiner  should  cut  out 
a  small  piece  of  the  fabric  stained,  and  suspend  it,  by  means 
of  a  thread,  in  a  test-tube  containing  cold,  distilled  water. 
In  a  few  minutes  the  coloring  matter  will  be  observed  to 
separate  from  the  material,  and  to  descend  to  the  bottom  of 
the  water,  forming  a  bright-red  solution.  If  the  stain  is  a 
little  older,  more  time  will  be  required  to  effect  the  solu- 
tion, which  will  have  a  browner  hue;  and  if  the  stain  is  very 
old,  there  will  be  no  solution  whatever. 

If  the  stain  be  upon  a  porous  substance,  such  as  wood* 
brick,  etc.,  it  should  be  cut  or  scraped  out,  reduced  to 
powder,  and  then  soaked  in  cold  water  for  some  hours,  and 
afterwards  filtered.  If  the  spot  be  upon  a  hard  metallic 
surface,  as  a  knife,  sword,  etc.,  it  should  be  carefully  dried, 
when  it  will  be  apt  to  crack  off;  otherwise  it  may  be 
scraped  off  with  a  knife,  and  the  scraping  soaked  for  some 
time  in  cold  water,  and  afterwards  filtered.  If  the  solution 
should  not  be  complete,  a  little  dilute  ammonia  may  be 
added,  and  if  this  should  fail,  Dr.  Tidy  recommends  to  use 
a  trace  of  citric  acid  to  effect  the  solution. 

Having  procured  the  clear  red  solution,  the  next  step  is 
to  heat  it  in  a  test  tube  over  a  spirit  lamp.  Four  results 
are  thus  obtained:  (i)  the  red  color  disappears  ;  (2)  coagula- 
tion takes  place ;  (3)  a  brownish-green  precipitate  is  formed. 
If  there  is  a  sufficient  quantity  of  this  precipitate  it  may  be 
collected,  dried  and  heated  with  a  weak  ammonia  solution, 
which  will  dissolve  it.  The  solution  will  appear  dark  green 
by  reflected,  and  red  by  transmitted  light.  (4)  A  weak 
solution  of  ammonia  added  to  it,  either  produces  no  change 
of  color,  or  it  merely  intensifies  it.  It  never  changes  it  to 
green  or  crimson,  as  it  does  with  cochineal,  and   red  fruit 


124  MEDICAL   JURISPRUDENCE. 

colors.  Tincture  of  galls  gives  a  red  precipitate  to  the 
original  solution.  A  solution  of  chlorine  causes  no  change 
in  it. 

The  above  tests  will  suffice  to  distinguish  blood  from  all 
other  red  solutions,  such  as  cochineal,  kino,  madder,  log- 
wood, and  the  various  red  fruit  juices,  none  of  which  coagu- 
late by  heat,  and  all  of  which  are  changed  in  color  by  the 
addition  of  ammonia.  The  stain  produced  by  lemon  or 
orange  juice  on  the  blade  of  a  knife  (citrate  of  iron)  after 
exposure  to  the  air,  may  bear  some  resemblance  to  an 
old  blood  stain  ;  but  the  test  of  tincture  of  galls,  or  of 
tannin,  to  the  solution  would  immediately  detect  the  differ- 
ence. So,  the  stain  from  red  paint  (which  contains  iron),  or 
from  iron  mould,  is  easily  identified  by  their  solubility  in 
dilute  muriatic  acid,  and  by  subsequently  testing  for  iron. 

The  Guaiacum  Test. — This  constitutes  a  beautiful  and 
satisfactory  portion  of  the  chemical  test  for  blood.  Dr. 
Day,  of  Australia,  has  experimented  extensively  upon  this 
test,  and  Prof.  Taylor  has  fully  confirmed  his  results.  It 
depends  upon  the  following  conditions  :  A  freshly-prepared 
tincture  of  guaiacum,  if  dropped  into  water,  precipitates  the 
resin,  which,  if  exposed  to  the  air,  gradually  acquires  a 
bluish  color.  If  it  be  exposed  to  a  jar  of  oxygen  gas,  the 
blueing  process  is  more  rapid ;  and  if  brought  in  contact 
with  ozone,  the  blue  color  is  instantly  produced.  Hence, 
the  blueing  must  be  owing  to  oxidation.  But  it  is  a  remark- 
able fact,  as  discovered  by  Schonbein,  that  antozone,  as  found 
in  the  peroxide  of  hydrogen  (in  which  the  oxygen  is  in  the 
positive  state),  has  no  effect  at  all  in  changing  the  guaiac 
resin  to  a  blue  color.  Moreover,  while  the  resin  is  blued 
by  a  variety  of  mineral  and  organic  substances,  the  coloring 
matter  of  the  blood  has  no  effect  upon  it.  The  guaiacum 
test  depends,  then,  upon  the  fact  that  while  the  blood  has  no 


THE    GUAIACUM    TEST.  125 

power  to  oxidize,  or  blue  the  resin,  the  presence  of  peroxide 
of  hydrogen  (antozone),  which  itself  has  no  power  to  oxidize 
the  guaiacum,  causes  the  resin  then  to  be  oxidized  by  the 
blood,  and  the  blue  color  appears.  According  to  Prof. 
Taylor,  an  excellent  way  of  showing  the  experiment  is  to 
add  a  few  drops  of  the  tincture  (freshly  prepared)  to  a  small 
quantity  of  water;  this  will  precipitate  the  resin.  Divide 
the  water  suspending  the  resin  into  two  portions  ;  into  one 
of  them  pour  a  little  solution  of  red  coloring  matter  of 
blood ;  to  the  other,  add  a  few  drops  of  ozonized  ether 
(peroxide  of  hydrogen  dissolved  in  ether) ;  no  change  of 
color  is  observed  in  either  portion.  Now,  to  the  first  por- 
tion add  a  few  drops  of  the  ether,  and  to  the  second  a  few 
drops  of  red  solution ;  in  both  cases  the  sapphire-blue  color 
will  soon  be  seen.  In  case  the  solution  is  turbid,  from  an 
excess  of  the  resin,  the  addition  of  a  few  drops  of  alcohol 
will  instantly  clear  it,  and  bring  out  the  fine  blue  color  dis- 
tinctly. If  the  simple  addition  of  the  blood  solution  to  the 
guaiac  produces  a  blue  color,  we  may  be  certain  that  some 
oxidizing  substance  is  present  besides  blood,  and  which 
conceals  its  presence.  The  force  of  the  experiment  consists 
in  the  fact  that  blood,  of  itself,  will  not  blue  guaiacum,  but 
in  the  presence  of  ozonized  ether,  the  blue  color  is  speedily 
produced. 

Objections  have  been  raised  against  this  test,  on  the 
ground  that  other  substances  beside  blood  will  produce  a 
blue  color  in  the  presence  of  guaiac  and  peroxide  of  hydro- 
gen, such  as  saliva,  bile  and  red  wine ;  but  as  regards  the 
two  former,  their  color  should  at  once  distinguish  them  from 
blood,  while  the  latter  substance  requires  some  hours'  ex- 
posure to  produce  the  same  result ;  whereas,  in  the  case  of 
blood  the  effect  is  immediate.  This  test  is  as  available  for 
old,  as  for  fresh  blood,  for  concentrated,  or  diluted  blood; 


\2l)  MEDICAL   JURISPRUDENCE. 

hence,  for  a  washed-out  blood  stain, — wherever,  in  fact,  a 
particle  of  red  coloring  matter  remains.  If  no  blueing 
occurs  in  the  presence  of  the  guaiac  and  the  peroxide,  it 
will  be  safe  to  affirm  that  there  is  no  blood  present.  In  an 
old  blood-stain,  or  where  it  is  too  small  to  afford  a  sufficient 
solution,  or  where  there  may  be  some  doubt  of  its  presence 
on  a  colored  material,  a  very  good  plan  is  to  moisten  the 
spot  first  with  a  few  drops  of  water,  then  with  a  sufficient 
quantity  of  the  guaiac  tincture,  and  afterwards  with  a  few- 
drops  of  the  ozonic  ether,  and  then  press  upon  it  a  piece  of 
white  tissue  or  filtering  paper;  immediately  there  will  appear 
upon  the  paper  the  characteristic  blue  stain.  A  number  of 
such  impressions  may  thus  be  taken  from  one  spot,  by  simply 
adding  a  little  more  of  the  guaiac  and  the  peroxide,  and 
repeating  the  pressure  upon  the  paper. 

The  chemical  tests  will  not  distinguish  arterial  from 
venous  blood,  nor  human  blood  from  that  of  the  lower 
animals.  The  statement  of  M.  Barruel,  that  if  blood  be 
shaken  up  with  one-third  its  volume  of  pure  sulphuric  acid, 
a  peculiar  odorous  principle  will  be  evolved,  resembling  the 
particular  animal  from  which  the  blood  was  obtained,  has 
been  disproved  by  subsequent  investigations. 

II.  The  Microscopic  Test. — This  consists  in  the  identifica- 
tion of  the  blood  corpuscles — especially  the  red  ones — by 
means  of  the  microscope.  To  effect  this,  the  stain  (unless 
too  old)  should  be  cut  out  and  placed  on  the  glass,  or  on  a 
watch  crystal,  and  moistened  with  a  few  drops  of  pure  cold 
water,*  a  glass  rod  being  pressed  against  it,  to  effect  the 
separation ;  then  cover  the  specimen  over  with  a  thin  glass, 

*  As  water  alone  may  cause  the  corpuscles  to  swell  up,  it  should  be  mixed 
with  one-seventh  part  of  glycerine,  or  with  a  small  portion  of  common  salt, 
or  sulphate  of  sodium. 


THE    MICROSCOPIC    TEST.  127 

and  examine  with  a  one-fourth  inch  power,  and  measure 
the  corpuscles  with  a  micrometer.  If  the  stain  has  been 
washed,  very  possibly  there  will  be  no  satisfactory  result; 
but  the  identification  of  a  single  red  corpuscle  would  be 
proof  of  the  presence  of  blood.  The  white  corpuscles  may 
sometimes  be  detected  where  the  red  disks  cannot  be  dis- 
tinguished. They  are  much  fewer  in  number  and  colorless. 
If  very  abundant  in  a  specimen,  they  might  be  owing  to  pus 
rather  than  to  blood,  or  to  disease  (leukaemia).  If  only  a 
minute  speck  of  dried  blood,  taken  from  a  weapon  or  from  a 
garment,  is  to  be  examined,  it  may  be  laid  upon  the  glass, 
which  has  previously  been  breathed  upon  several  times,  and 
after  again  breathing  upon  it,  it  should  be  covered  with  the 
thin  slide,  and  examined,  as  before.  The  condensed  moisture 
of  the  breath  serves  the  place  of  water  in  breaking  up  the 
dried  clot,  without  destroying  the  corpuscles  by  too  much 
dilution  (Dr.  A.  Taylor,  from  Casper). 

The  human  blood  corpuscle  is  a  round,  bi-concave  disk, 
without  a  nucleus.  All  mammalian  corpuscles  have  the 
same  form,  with  the  exception  of  those  of  the  camel  tribe, 
which  are  oval.  The  corpuscles  of  birds,  reptiles  and  fishes 
are  oval,  larger  in  size,  and  nucleated.  It  is  well  to  remem- 
ber that  oval  corpuscles  may  becorrTe  globular  by  treatment 
with  an  excess  of  water.  The  outlines  of  dried  blood  cor- 
puscles are  irregular  and  jagged,  and  more  or  less  stellate. 

The  average  diameter  of  the  human  blood  corpuscle  is 
about  the  32W  of  an  inch  (max.  2oV<r,  min.,  ^oVo,  Gulliver). 
The  average,  according  to  Taylor,  is  3oV<j  of  an  inch  (max., 
Wo,  min.,  saVo).  The  corpuscles  of  most  of  the  lower  ani- 
mals are  smaller  than  those  of  man.  The  average  diameter 
in  the  monkey  is  rh*  of  an  inch  ;  of  the  dog,  szwu;  of  the 
horse,  TeVo ;  of  the  cow,  * fan ;  of  the  goat,  o -fW ;  of  the  sheep, 
Wi-;    of  the  cat,  jfai;  of  the  pig,  ^hs;    of  the  mouse,  jst?; 


128  MEDICAL   JURISPRUDENCE. 

of  the  hare,  -  -1  --..  From  the  above  enumeration  it  will  be 
seen  that  the  monkey,  dog  and  hare,  and,  perhaps,  the  mouse, 
are  the  animals  whose  blood  corpuscles  most  closely  ap- 
proximate in  size  to  those  of  man,  while  those  of  the 
domestic  animals  whose  blood  would  be  most  likely  to  be 
confounded  with  human  blood,  viz.,  the  horse,  caw,  pig, 
sheep  and  goat,  are  notably  smaller  than  the  human.  The 
corpuscles  of  birds,  reptiles  and  fishes,  as  already  mentioned, 
are  oval  in  shape,  and  considerably  larger  than  those  of 
mammals.  The  long  diameter  of  the  corpuscle  of  the 
common  eel  is  ttit  of  an  inch;  the  short  diameter, 
of  the  shark,  long  diameter,  tttt,  short  diameter,  xArv;  of 
the  turtle,  long  diameter,  nrrr,  short  diameter,  tiV?  ;  of  the 
Congo  lizard,  long  diameter,  aib,  short  diameter,  m;  of 
the  proteus,  long  diameter,  twss  short  diameter,  t*t;  of  the 
frog,  long  diameter,  ttVt,  short  diameter,  tiVt;  of  the  pigeon, 
long  diameter,  irrV<j,  short  diameter,  s^rs;  of  the  common 
fowl,  long  diameter,  -tV?,  short  diameter,  ttVs;  of  the  duck, 
long  diameter,  tsVt,  short  diameter,  stVt. 

The  important  medico-legal  question  in  connection  with 
blood-stains  is,  whether  it  is  possible  to  distinguish  human 
blood  from  that  of  one  of  the  lower  animals.  Of  course, 
there  can  be  no  difficulty  in  recognizing  this  difference  in 
the  case  of  birds,  reptiles  and  fishes  ;  the  shape  and  size  of 
the  corpuscles,  in  each  of  these  orders,  will  at  once  make  it 
manifest.  But  as  regards  the  blood  of  the  common  domes- 
tic animals,  such  as  the  cow,  horse,  pig  and  goat,  the  diffi- 
culty is  vastly  increased.  In  a  case  of  homicide,  where  a 
blood-stained  garment  might  constitute  an  important  link  in 
the  chain  of  evidence,  and  where  the  accused  might  very 
naturally  assert  that  the  suspicious  stains  were  accidentally 
caused  by  the  blood  of  one  of  these  animals,  it  becomes  of 
unspeakable   importance   to   be  able  to  decide   this   point. 


IDENTIFICATION    OF    HUMAN    CORPUSCLES.  129 

Until  within  a  few  years  it  has  been  considered  impossible 
to  give  a  positive  answer  to  this  question.  To  Prof.  J.  G. 
Richardson,  of  Philadelphia,  is,  we  think,  justly  due  the 
merit  of  having  demonstrated  the  possibility  of  distinguishing 
between  human  blood  and  that  of  the  horse,  cow,  sheep,  pig 
and  goat — those  animals  whose  blood  would  be  most  likely 
to  be  confounded  with  that  of  man.  He  has  conclusively 
shown  that,  by  employing  very  high  microscopic  powers, 
such  as  the  3V  of  an  inch  objective,  magnifying  with  a 
micrometer  eye-piece  over  3000  diameters,  the  human 
corpuscle  appears  about  t  of  an  inch  in  diameter,  whilst 
those  of  the  ox  and  sheep  are  about  I  of  an  inch  in  diameter, 
indicating  a  very  obvious  difference  in  their  respective  sizes. 
The  use  of  the  ordinary  powers  (500  or  600  diameters)  fails 
entirely  to  recognize  the  difference. 

It  is  certainly  to  be  regretted,  for  medico-legal  reasons, 
that  the  size  of  the  blood  corpuscles  of  the  monkey,  dog  and 
rabbit  approximates  so  closely  to  that  of  the  human  corpuscle, 
that  it  is  not  possible,  by  the  microscope,  nor  by  any  means 
yet  discovered,  to  recognize  the  distinction  between  them ;  but 
it  is  equally  no  slight  triumph  for  microscopic  science  to  have 
accomplished  as  much  as  it  has  done.  In  several  homicide 
cases,  Prof.  Richardson  has  been  able  to  give  most  positive  and 
valuable  testimony  as  to  the  identity  of  human  blood-stains, 
by  his  microscopic  researches.  His  method  of  procedure  is  to 
scrape  off  a  minute  particle  of  the  suspected  blood-clot  from 
the  stained  article  with  the  point  of  a  cataract  needle,  letting 
it  fall  upon  a  clean  microscopic  slide.  A  thin  cover  is  then 
laid  upon  the  fragment,  and  pressed  down  firmly,  so  as  to 
crush  the  particle  to  powder,  and  the  whole  transferred  to 
the  stage  of  the  microscope.  Pure  water  should  be  intro- 
duced at  the  margin  of  the  cover,  and  allowed  to  flow  very 
slowly  towards  the  specimen  ;  when  this  is  reached,  a  niovc- 
7 


130  MEDICAL   JURISPRUDENCE. 

ment  is  observed,  after  which  an  aggregation  of  compressed 
corpuscles,  very  faint  and  colorless,  but  yet  very  distinct, 
conies  into  view.  These  arc  rendered  more  obvious  by 
introducing  at  the  margin  of  the  cover  a  minute  portion  of 
iodine,  or  red  aniline  solution.*  The  author  has  verified,  by 
personal  experiment,  the  correctness  of  Prof.  Richardson's 
deductions.  On  one  occasion,  specimens  of  dried  human 
blood,  together  with  that  of  the  ox,  horse  and  sheep,  were 
submitted,  unmarked,  to  Prof.  R.,  for  microscopic  examin- 
ation, and  the  correct  result  was  returned  in  every  instance. 

It  may  be  proper  to  allude  to  certain  bodies  that  might 
be  mistaken,  under  the  microscope,  for  blood  corpuscles, 
such  as  starch-granules,  the  sporules  of  fungi,  and  the  disks 
of  coniferous  woods.  But  as  these  generally  possess  certain 
special  marks  by  which  they  can  be  recognized,  they  need 
never  be  confounded  with  blood  disks,  by  a  practiced 
microscopist. 

Blood  Crystals  constitute  another  test  for  blood.  They 
can  be  obtained  from  all  kinds  of  red  blood,  being,  in  fact, 
due  to  the  crystallization  of  the  haemoglobin.  To  procure 
them,  according  to  Lehmann,  evaporate  a  drop  of  blood  to 
dryness  on  a  piece  of  glass,  add  a  drop  of  distilled  water, 
and  cover  the  whole  with  a  slip  of  thin  glass.  After  a  time, 
when  the  water  has  nearly  evaporated,  microscopic  crystals, 
of  various  sizes  and  forms,  are  visible.  Those  of  man  are 
prismatic,  or  rhomboidal ;  those  of  the  inferior  animals  are 
either  similar  in  shape,  or  else  tetrahedral  or  hexagonal.  In 
order  to  procure  crystals  from  the  blood  stains  upon  a  fabric, 
such  as  linen  or  muslin,  or  from  a  dried  coagulum,  the  pro- 
cess of  Kunze  and  Neumann  seems  to  be  the  best.  This 
consists  in  soaking  the  stained  portion  for  several  hours  in 
a  small  quantity  of  cold  water,  until  the  coloring  matter  is 
*  Vid.  Am.  Jour.  Med.  Sci  ,  July,  1874. 


THE    SPECTROSCOPIC    TEST.  131 

dissolved ;  the  reddish  solution  is  then  evaporated  to  dry- 
ness; the  dry  residue  boiled  with  an  excess  of  glacial  acetic 
acid,  until  a  red  solution  is  procured  ;  this  is  then  slowly 
evaporated  on  a  glass  slide  until  the  crystals  form,  when 
they  are  examined  by  a  power  of  500  diameters.  The 
blood  crystals  appear  in  groups,  frequently  crossing  one 
another,  intermixed  with  cubic  crystals  of  chloride  of 
sodium.  But  the  similarity  of  human  blood  crystals  to 
those  of  the  lower  animals  is  too  great  to  permit  of  the 
forming  of  a  positive  diagnosis  as  to  their  real  origin. 
Consequently,  they  cannot  be  regarded  as  affording 
much  practical  assistance  in  the  identification  of  blood 
stains. 

III.  The  Optical  or  Spectroscopic  Test. — The  application 
of  the  spectroscope  to  the  identification  of  blood  depends 
upon  the  fact  that  various  colored  solutions  possess  the 
power  of  absorbing  different  portions  of  the  spectrum,  and 
of  producing  in  the  latter  certain  dark  lines,  just  as  certain 
vapors  and  gases  affect  the  spectrum.  Blood,  in  this  respect, 
produces  a  very  decided  effect,  causing  absorption  bands 
(dark  lines),  which  are  very  characteristic  of  its  presence, 
even  in  minute  quantities. 

It  will  be  remembered  that  in  perfectly  fresh  arterial 
blood,  the  coloring  matter  exists  as  haemoglobin.  (1)  When 
this  is  examined  by  the  spectroscope,  it  will  be  seen  to  pro- 
duce tivo  absorption  bands  in  the  spectrum,  in  the  yellower 
half  of  the  green  space,  the  lower  one  being  twice  as  broad 
as  the  upper ;  also  the  blue  end  is  darkened.  When  haemo- 
globin is  acted  upon  by  acids  and  alkalies,  or  kept  for  a  long 
time,  especially  in  a  damp  place,  it  acquires  a  brown  color, 
becomes  deoxidized,  and  is  finally  changed  into  hcematin. 
(2)  The  spectrum  of  deoxidized  haemoglobin,  or  of  venous 


132  MEDICAL   JURISPRUDENCE. 

blood,  shows  a  single  broad  absorption  band,  visible  in  the 
green ;  the  blue  end  is  also  darkened.  (3)  After  a  short 
exposure  to  the  air  {metlicemoglobiii),  it  gives  a  spectrum 
with  the  blue  end  darkened,  the  two  bands  of  oxidized 
haemoglobin  much  weakened,  with  a  third  band  visible  in 
the  red.  (4)  The  spectrum  of  deoxidized  haematin,  or  of 
blood  after  prolonged  exposure  to  air,  shows  the  blue  end 
darkened,  and  two  well-defined  bands  in  the  green,  but 
stronger  than  in  (1),  and  with  disappearance  of  the  band  in 
the  red. 

The  form  of  apparatus  best  adapted  for  spectroscopic  ex- 
amination of  blood  is  that  suggested  by  Mr.  Sorby,  to 
whose  researches  we  are  chiefly  indebted  for  our  knowl- 
edge in  this  branch  of  investigation.  It  is  a  combination 
of  the  microscope  and  spectroscope.  The  blood  solution  is 
prepared  in  the  same  manner  as  that  described  above  for 
the  chemical  tests.  The  details  of  the  examination  by  the 
spectroscope  would  exceed  the  limits  of  this  work ;  the 
reader  is  referred  to  the  larger  treatises  for  a  fuller  de- 
scription. 

The  important  question  in  this  connection  is — Do  other 
substances  give  similar  spectra  to  those  of  blood  ?  Accord- 
ing to  Mr.  Sorby,  nothing  gives  a  spectrum  precisely  similar 
to  that  produced  by  oxy-haemoglobin,  although  certain 
other  bodies  produce  absorption  lines  somewhat  resembling 
the  former,  but  easily  distinguishable  by  a  practiced  observer. 
Thus,  the  coloring  matter  of  the  petals  of  Cineraria  give 
two  absorption  bands;  but  they  are  easily  distinguished 
by  the  action  of  ammonia.  Cochineal,  madder,  and  other 
red  dyes,  dissolved  in  alum,  although  affording  bands  some- 
what resembling  those  produced  by  blood,  may  be  distin- 
guished from  the  latter  by  the  use  of  ammonia  and  potassic 
sulphite. 


THE    SPECTROSCOPIC    TEST.  133 

We  must,  therefore,  admit  that  the  spectroscope,  in  the 
hands  of  a  skilled  operator,  affords  the  most  certain  and 
delicate  test  known  for  the  presence  of  blood.  It  cannot, 
however,  discriminate  between  human  blood  and  that  of  any 
of  the  lower  animals;  in  this  respect,  therefore,  it  is  inferior 
to  the  microscope  as  a  test. 


131  MEDICAL   JURISPRUDENCE. 


CHAPTER  VIII. 

BURNS  AND  SCALDS. 

DEFINITION. — CLASSIFICATION. — SYMPTOMS. — CAUSE  OF  DEATH. — 
POST-MORTEM  APPEARANCES. — DISTINCTION  BETWEEN  BURNS  MADE 
BEFORE  AND  AFTER  DEATH. — ACCIDENTAL,  SUICIDAL  AND  HOMI- 
CIDAL BURNS. — SPONTANEOUS   COMBUSTION. 

A  burn  is  an  injury  to  the  body,  caused  by  heat  applied 
either  in  the  form  of  a  heated  solid  substance,  or  by  flame, 
or  by  radiant  heat. 

A  scald  is  an  injury  produced  by  a  liquid,  heated  above 
a  certain  point,  applied  to  the  body. 

Burns  and  scalds  are  not,  strictly  speaking,  wounds; 
though  legally  they  are  comprised  under  the  term  bodily 
injuries.  The  effects  of  corrosive  liquids,  such  as  sulphuric 
and  other  mineral  acids,  and  the  strong  alkalies,  closely 
resemble  burns,  and  they  are  so  regarded  in  law.  Boiling 
liquids  taken  internally  may  produce  internal  scalds. 

The  intensity  of  a  burn  is  dependent  upon  the  degree  of 
heat  applied;  it  varies  from  a  slight  redness,  to  a  complete 
charring  of  the  tissues.  Metals  heated  to  redness  produce 
very  severe  burns,  even  to  the  destruction  of  the  flesh ;  but 
if  in  a  state  of  fusion,  the  injury  is  yet  more  serious,  in  con- 
sequence of  the  partial  adhesion  of  the  molten  mass  to  the 
skin.  Boiling  oils  produce  as  decided  effects  as  hot  solids 
or  molten  metals.  Boiling  ivater  causes  scalds,  more  or  less 
severe,  attended  with  vesications  containing  serum ;  but  it 
never  chars,  or  destroys  the  tissue. 

According  to  Dupuytren,  burns  may  be  classified  as 
follows : — 


CLASSIFICATION    OF    BURNS.  135 

(i)  Superficial  inflammation  of  the  skin,  without  vesication. 

(2)  Vesication,  or  blisters,  containing  serum,  sometimes 
clear  and  sometimes  opaque  and  bloody.  If  the  cuticle  be 
removed,  the  true  skin  is  very  red  and  granulated,  and 
secretes  pus. 

(3)  Destruction  of  the  external  surface  of  the  true  skin, 
forming  an  eschar,  which  may  be  soft  and  yellow  if  made 
by  a  liquid,  or  hard  and  brown,  or  black,  if  resulting  from  a 
solid.  The  surrounding  skin  is  red  and  blistered.  This 
form  of  burns  leaves  ugly  cicatrices,  which  are  white  and 
shining. 

(4)  Disorganization  of  the  whole  skin :  these  differ  from 
the  last  only  in  the  deeper  destruction  of  the  parts,  and  in 
the  thickness  of  the  sloughs.  The  resulting  scars  arc 
puckered,  and  depressed  below  the  level  of  the  skin. 

(5)  The  destruction  here  extends  through  the  skin,  and 
includes  the  cellular  tissue  and  a  portion  of  the  muscles. 
The  general  character  is  the  same  as  in  (4). 

(6)  Complete  carbonization  of  the  burnt  part,  as  when  a 
portion  of  the  body  is  roasted  by  the  fire. 

The  important  medico-legal  question  to  determine  is — was 
the  burn  upon  the  body  made  before,  or  after  death  ?  It  is 
evident  that  an  assassin  might  murder  his  victim,  and  then 
set  fire  to  the  house,  hoping  thus  to  escape  detection.  If  a 
body  be  found  completely  charred,  it  will  be  impossible  to 
determine  whether  it  was  living  or  dead  when  acted  upon 
by  the  heat. 

As  regards  vesications,  which  result  from  moderately 
heated  solids,  or  from  scalding  liquids,  if  they  contain 
serum,  their  presence,  as  a  rule,  indicates  that  the  burn  was 
inflicted  during  life.  The  experiments  of  Christison,  Taylor 
and  Tidy  go  to  show  that,  although  the  application  of  heat 
to  a  body  within  a  few  minutes  after  death  may  sometimes 


J3li  MEDICAL   JURISPRUDENCE. 

produce  a  blister,  this  does  not  contain  serum,  but  only  air; 
serous  exudation  must  be  regarded  as  vital.  There  may  be 
an  exception  to  the  above  rule  in  the  case  of  dropsical  sub- 
jects, in  whom  it  is  stated,  on  good  authority,  that  serous 
blisters  may  be  produced  after  death,  by  the  application  of 
heat.  But,  on  the  other  hand,  the  absence  of  vesication 
should  not  be  regarded  as  a  proof  that  the  burn  was  not 
inflicted  during  life,  since  vesication  is  not  always  a  neces- 
sary result  of  a  burn ;  besides,  it  is  quite  possible  that  only 
the  more  serious  results  maybe  visible.  It  is  recommended, 
in  all  doubtful  cases,  to  examine  the  cuticle  minutely,  with 
a  lens,  for  minute  apertures  through  whicn  the  serum  may 
have  escaped. 

Another  sign  of  burning  during  life  is  the  presence  of  a 
red  line  around  the  burn,  which  gradually  merges  into  the 
color  of  the  surrounding  skin.  This  red  border  remains 
after  death,  and  cannot  be  produced,  according  to  Christi- 
son  and  Taylor,  by  the  application  of  heat  to  the  dead 
body.  Dr.  Tidy's  conclusions  {Legal  Med.,  vol.  I,  p.  482), 
based  upon  a  series  of  his  own  experiments,  are  that  "where 
there  are  serous  blisters  on  a  dead  body,  the  serum  being 
thick  and  rich  in  albumen,  and  the  blisters  surrounded  by 
a  deeply  injected  red  line,  the  true  skin,  after  the  removal 
of  the  cuticle,  also  presenting  a  reddened  appearance,  the 
evidence  is  strong  that  the  burn  was  produced  during  the 
life  of  the  person;  while  it  is  conclusive  that  it  was  caused 
during  the  life  of  the  part.  But  if  the  blister  contained  air, 
the  true  skin,  after  the  removal  of  the  cuticle,  appearing  dry 
and  unglazed,  of  a  dull  white  color  or  grayish  ;  or,  if  the 
blister  contains  a  little  thin,  non-albuminous  serum,  there- 
being  in  neither  case  any  red  surrounding  line,  nor  any  in- 
jected condition  of  the  cutis  zvrtf,the  evidence  is  strong  that 
the  burn  was  inflicted  after  death." 


POST-MORTEM    APPEARANXES    OF    BURNS.  lo7 

The  Danger  of  burns  depends  more  on  their  extent  than 
their  depth.  The  reason  of  this  is  that  extensive  burns 
involve  a  greater  number  of  sensory  nerves,  and  a  greater 
extent  of  surface  is  prevented  from  performing  the  function 
of  excretion  and  heat  regulation.  Thus,  a  large  superficial 
scald,  especially  in  young  children,  is  very  apt  to  prove 
fatal,  the  symptoms  being  stupor,  somnolence,  pallor  of 
face,  and  feeble  pulse,  with  slow  and  stertorous  breathing — 
very  similar  to  those  of  narcotic  poisoning,  for  which,  indeed, 
they  have  sometimes  been  mistaken.  It  has  been  ascer- 
tained that  if  one-half  to  two-thirds  of  the  entire  skin  be 
involved,  the  burn  will  certainly  prove  fatal;  but  practi- 
cally, one  involving  one-third  of  the  body,  if  severe,  would 
be  very  likely  to  cause  death.  But  here,  many  circum- 
stances will  have  to  be  considered,  such  as  the  age,  consti- 
tution, the  part  affected,  and  the  character  of  the  burn.  Burns 
are  more  dangerous  in  the  young;  more  so  on  the  trunk  of 
the  body  than  on  the  limbs;  and  more  so  if  in  separate 
patches  than  if  continuous,  provided  they  are  of  equal 
extent.  Gunpowder  burns  are  considered  more  dangerous 
than  those  produced  by  steam. 

The  Causes  of  death  in  burns  are  various:  as  (i)  bodily  in- 
jury; as  in  the  case  of  conflagrations  of  buildings,  where 
instantaneous  death  may  result  from  the  fall  of  timbers, 
walls,  etc.,  or  from  leaping  out  of  a  window,  or  from  a  roof. 
(2)  Suffocation,  either  from  the  smoke,  or  from  the  want  of 
air.  (3)  Shock;  this  is  probably  the  most  frequent  cause 
of  death  after  extensive  burns.  (4)  Coma,  convulsions  or 
tetanus.  (5)  Bronchitis,  pneumonia  and  other  thoracic 
symptoms.  (6)  Enteritis  and  peritonitis.  (7)  Exhaustion. 
(8)  Gangrene,  pyaemia,  etc. 

The  Post-mortem  appearances. — These  are  often  by  no 
means    well    marked,  the    most   constant    lesions    being    a 

7* 


138  MEDICAL   JURISPRUDENXE. 

capillary  injection  of  the  mucous  membrane  of  the  ali- 
mentary canal  and  bronchi,  and  serous  effusion  into  the 
ventricles  of  the  brain.  In  cases  where  the  death  has  oc- 
curred from  injury,  or  from  suffocation,  the  usual  lesions 
would,  of  course,  be  discovered  after  death ;  but  if  the  body 
has  been  completely  charred  or  roasted,  it  will  probably  be 
impossible  to  distinguish  anything  to  enable  us  to  form  an 
opinion  as  to  whether  the  death  had  preceded  the  burning 
or  not.  The  means  of  identifying  the  charred  remains  of  a 
burnt  body  have  already  been  pointed  out  (ante,  p.  88). 

Wounds  upon  the  burned. — From  the  fact  that  murder  is 
frequently  committed,  and  the  body  subsequently  burned 
by  a  criminal,  with  a  view  of  destroying  the  traces  of  his 
crime,  it  is  important  for  the  legal  physician  always  to  ex- 
amine the  body  for  wounds.  There  are  certain  mechanical 
effects  produced  upon  the  body  by  fire,  which  might  possi- 
bly be  mistaken  for  wounds  made  before  death,  such  as 
fissure  in  the  thorax  or  abdomen,  or  in  the  neighborhood 
of  the  large  joints.  These  fissures  are  generally  irregular 
in  form,  and,  as  the  blood  vessels,  by  their  elasticity,  are 
apt  to  escape  being  torn,  these  may  be  seen  intact,  stretch- 
ing across  the  fissure.  This  appearance  is  always  indicative 
that  the  opening  was  caused  by  heat,  and  was  not  a  real 
wound.  A  case  is  mentioned  in  which  two  old  people  were 
found  burned  in  their  house ;  the  fact  of  their  having  been 
previously  stunned,  if  not  killed,  by  blows  on  the  head,  was 
ascertained  by  the  existence  of  fractures  of  the  skull,  under 
which  coagulated  blood  was  found  upon  the  dura  mater. 
Where  the  heat  has  been  excessive,  the  bones  of  the  de- 
ceased may  be  found  more  or  less  cracked  or  split,  and 
sometimes  even  crumbled  to  pieces.  Ordinary  incised, 
punctured  or  contused  wounds,  made  before  death,  could 
not  be  identified  in  a  body  completely  charred  by  fire. 


SPONTANEOUS   COMBUSTION.  139 

As  to  the  question  of  the  burning  being  accidental,  suicidal 
or  homicidal,  it  may  be  assumed  that  death  by  burning  is 
nearly  always  accidental ;  and  such  cases  are,  unfortunately, 
of  frequent  occurrence.  Death,  in  such  instances,  mostly 
occurs  at  some  distance  from  the  fire.  The  fact  that  a  dead 
body  is  found  near  the  fire  does  not,  however,  preclude  the 
idea  of  accident,  since  an  intoxicated  or  a  diseased  person 
may  have  caught  fire,  and  been  unable  to  remove.  In  all 
such  cases  it  is  important  to  examine  the  body  for  marks  of 
violence,  with  the  precautions  given  above.  Furthermore, 
a  case  might  present  itself  where  severe  wounds  were  found 
on  a  burnt  body,  and  the  question  might  arise  whether  the 
wounds,  or  the  fire  had  been  the  cause  of  death  ?  No 
general  rules  can  be  given  for  guidance  in  such  cases ;  each 
one  must  be  determined  by  the  attending  circumstances. 

The  question  of  Spontaneous  Combustion  of  the  human  body 
presents  itself  here  for  a  brief  notice.  It  has  occasioned 
considerable  discussion  in  the  scientific  world  for  many 
years  past,  but  although  some  remarkable  instances  are 
related  of  apparent  spontaneous  combustion  of  the  human 
body,  originating  while  alive,  we  believe  that,  on  close  inves- 
tigation, it  will  be  found  that  some  source  of  fire  had  invari- 
ably been  present,  from  which  the  combustion  took  its 
origin — such  as  a  lighted  pipe  or  candle, — and  that  the  body 
was  that  of  an  habitual  spirit  drinker,  and  nearly  always  that 
of  a  very  fat  woman — conditions  highly  favorable  for  the 
process  of  combustion,  when  once  originated. 

From  the  known  composition  of  the  human  body — nearly 
75  per  cent,  being  water — it  would  seem  to  be  chemically 
and  physiologically  impossible  even  to  burn  up  a  dead  body, 
except  on  the  application  of  an  extraordinary  degree  of  heat, 
such  as  is  required  by  the  process  of  cremation.  Certainly, 
the  weight  of  authority  is  against  the  belief  in  spontaneous 


140  MEDICAL   JURISPRUDENCE. 

combustion  of  the  human  body;  no  person  of  position  or 
authority  has  ever  witnessed  such  a  phenomenon,  and  we 
must  therefore  express  our  disbelief  in  it,  and  assign  the 
wonderful  accounts  which  from  time  to  time  have  appeared 
in  the  newspapers  and  books  to  the  region  of  romance  and 
fiction. 

It  is,  of  course,  an  admitted  fact  that  various  organic 
and  mineral  substances  undergo  spontaneous  combustion, 
through  the  agency  of  absorbed  oxygen,  especially  when 
exposed  to  the  action  of  the  air,  in  a  state  of  fine  powder  or 
extended  surface.  Conflagrations  of  large  buildings  have 
frequently  thus  originated,  involving  important  legal  ques- 
tions as  to  incendiarism. 


VIOLENT    DEATH    FROM    APNiJEA.  1-11 


CHAPTER   IX. 

VIOLENT  DEATH  FROM  DIFFERENT  FORMS  OF  APNCEA 
(ASPHYXIA). 

This  includes  death  from  Suffocation,  Strangulation, 
Hanging  and  Drowning,  in  all  of  which  life  is  destroyed 
chiefly,  if  not  exclusively,  by  apncea  or  asphyxia.  All  these 
modes  of  violent  death  possess  certain  points  in  common, 
while,  at  the  same  time,  each  of  them  is  distinguished  by 
individual  peculiarities,  which  render  a  separate  consideration 
desirable.  Their  common  properties  will  be  first  briefly 
considered. 

In  all  cases  of  apncea,  it  will  be  remembered  that  death 
begins  in  the  lungs,  and  that  this  is  brought  about  simply 
by  excluding  the  air  (oxygen)  from  these  organs.  This  is 
accomplished  by  numerous  and  diverse  means :  as  by 
mechanical  pressure  upon  the  throat  or  thorax,  as  in 
throttling  ;  by  a  ligature  around  the  throat,  as  in  hanging 
and  strangling  ;  by  the  flow  of  water  into  the  windpipe, 
as  in  drowning;  by  foreign  bodies  getting  into  the  larynx 
and  trachea,  as  in  choking;  by  being  shut  up  in  a  box 
(entombed  alive),  or  buried  under  ruins,  or  a  sand  bank,  or 
snow  drift ;  or  by  some  disease  of  the  throat,  as  oedema  of 
the  glottis,  membranous  croup,  etc.; — all  of  which  produce 
death  simply  by  arresting  the  function  of  respiration. 

Likewise,  there  are  exhibited  certain  signs  or  phenomena, 
both  before  and  after  death,  which  indicate  death  by  apncea. 
These  are  lividity  of  the  lips,  fingers,  and  other  extremi- 
ties, and  generally  of  the  whole  face,  together  with  a 
swollen  appearance   of  the  countenance  ;  convulsive  move- 


142  MEDICAL   JURISPRUDENCE. 

ments  of  the  arms  and  legs,  at  first  partly  voluntary,  but 
soon  becoming  spasmodic  and  involuntary,  as  seen  in  the 
struggles  to  breathe ;  the  veins  become  turgid  ;  the  pulse,  at 
first  full  and  rapid,  soon  becomes  feeble ;  there  is  often 
frothing  at  the  mouth,  which  may,  at  times,  be  tinged  with 
blood  ;  there  is  frequently  turgescence  of  the  genital  organs, 
with  involuntary  discharge  of  semen,  urine  and  faeces. 
Abortive  attempts  at  respiration  are  made  for  awhile,  but 
finally  these  cease,  and  the  heart  at  last  ceases  to  pulsate. 

Consciousness  is  lost  very  early,  although  in  the  earliest 
stage  there  is  a  remarkable  activity  of  the  senses ;  the 
memory  is  surprisingly  acute,  so  that  the  events  of  a  life- 
time seem  to  be  crowded  into  a  moment.  But  this  stage 
only  lasts  for  a  very  brief  space  of  time ;  such  is  the  testi- 
mony of  persons  who  have  been  rescued  from  drowning,  or 
who  have  been  cut  down  from  hanging,  and  of  those  who 
have  experimented  upon  themselves  by  partial  strangulation. 

This  kind  of  death  is  rapid,  not  requiring  more  than  three 
to  five  minutes,  though  there  are  some  apparent  exceptions 
in  the  case  of  drowning.  These  will  be  referred  to  here- 
after. 

The  post-mortem  appearances  in  all  these  varieties  of 
death  by  apncea  are,  in  the  main,  very  similar.  These  are 
lividity  of  the  lips,  fingers  and  other  parts  of  the  body,  as 
seen  before  death  ;  in  drowning,  the  face  is  apt  to  be  pale ; 
sometimes,  likewise,  in  /tanging.  The  venous  system  is  gen- 
erally full  of  blood.  The  right  side  of  the  heart,  together 
with  the  lungs,  is  usually  gorged  with  dark  blood;  the 
mucous  membrane  of  the  bronchial  tubes  deeply  congested. 
In  young  persons,  the  blood  vessels  of  the  lungs  will  often 
be  found  empty,  and  the  lungs  emphysematous,  from  the 
violent  efforts  made  to  respire.  Minute  extravasations  of 
blood  (ecchymoses)  are  found  in   the  mucous  and  serous 


SUFFOCATION.  143 

membranes,  as  the  pleura,  pericardium,  endocardium,  peri- 
toneum, etc.  (Tardieu).  The  veins  and  sinuses  of  the  brain 
are  usually  tinged  with  blood,  and  the  brain  itself  filled  with 
bloody  points.  The  solid  viscera,  as  the  liver,  spleen  and 
kidneys,  will  generally  be  congested.  The  blood  itself  is 
mostly  fluid  and  dark  colored,  except  in  suffocation  from 
carbonic  acid,  when  its  color  is  bright  red. 

SECTION    I. 
DEATH   BY  SUFFOCATION. 

ACCIDENTAL     SUFFOCATION. — SUICIDAL    AND     HOMICIDAL    SUFFOCA- 
TION.— POST-MORTEM   SIGNS. 

Suffocation,  properly  speaking,  includes  every  variety  of 
death  resulting  from  an  impediment  to  respiration.  But,  as 
Strangulation,  Hanging  and  Drowning  are  considered  sepa- 
rately, the  term  is  here  restricted  to  the  other  modes  of 
death  by  apneea. 

Cases  of  accidental  suffocation  are  numerous.  Infants 
have  thus  perished  by  being  too  closely  wrapped  up,  or  by 
being  overlaid  by  their  mothers,  who  are  often  intoxicated. 
Young  children,  feeble  persons,  epileptics  and  drunkards, 
have  been  suffocated  by  falling  into  ashes,  soft  mud,  feathers 
and  similar  articles.  Mechanical  pressure  on  the  thorax,  as 
occurs  in  vast  crowds  of  people,  has  destroyed  life  by  suffo- 
cation. The  accidental  slipping  into  the  larynx  of  small 
bodies,  such  as  peas,  grains  of  corn,  marbles,  etc.,  from  the 
mouth,  particularly  in  children  ;  the  lodgment  of  a  piece  of 
meat  in  the  air  passages  (choking),  from  over-haste  in  eat- 
ing ;  the  detachment  of  a  bronchial  gland  which  became 
impacted  in  the  larynx ;  the  escape  of  a  lumbricus  from  the 
stomach, and  its  entering  the  larynx;  the  passing  of  vomited 
matters  into  the  windpipe;  various  disorders  of  the  throat, 


144  MEDICAL    JURISPRUDENCE. 

as  oedema  and  spasm  of  the  glottis,  croup,  diphtheria, 
abscess,  etc. — all  these  are  examples  of  accidental  suffoca- 
tion. 

Suicidal  suffocation  is  extremely  rare,  though  a  few  re- 
markable cases  are  mentioned  by  authors,  in  one  of  which — 
that  of  a  young  woman — death  was  caused  by  a  ball  of  hay 
which  she  had  thrust  down  the  throat  into  the  pharynx, 
behind  the  larynx,  and  which  was  just  visible  when  the 
mouth  was  widely  opened  [Year  Book  of  Med.  and  Surg., 
1864,  p.  458). 

Homicidal  suffocation  is  usually  practiced  upon  infants, 
the  aged,  or  those  who  are  otherwise  helpless.  Suffocation 
is  undoubtedly  a  very  common  mode  of  destroying  new- 
born children  ;  it  is  very  easily  effected,  and  leaves  behind 
it  no  characteristic  traces ;  death,  in  such  cases,  being 
usually  attributed  to  convulsions.  The  notorious  Edin- 
burgh murderers,  Burke  and  Mare,  destroyed  their  victims 
by  suffocation  by  forcibly  closing  their  mouth  and  nostrils, 
and  at  the  same  time  bearing  their  whole  weight  upon  their 
breast.  A  curious  Scotch  case  is  mentioned,  where  an  in- 
temperate woman,  between  sixty  and  seventy  years -of  age, 
was  found  dead  with  a  wound  upon  the  scalp,  emphysema 
in  the  chest,  and  seven  ribs  fractured.  The  face  was  pale 
and  composed,  the  eyes  closed,  and  the  tongue  slightly 
protruding.  On  examination,  the  cork  of  a  quart  bottle 
was  found  in  her  larynx,  the  sealed  end  being  uppermost. 
The  epiglottis,  trachea  and  larynx  were  considerably  injected. 
It  was  attempted,  on  the  trial,  to  show  that  the  deceased 
had  drawn  out  the  cork  with  her  teeth,  but  that  it  was  sud- 
denly forced  into  her  windpipe,  while  she  was  dead  drunk. 
But  this  was  negatived  by  the  fact  that  the  sealed  end  of  the 
cork  was  uppermost,  and  also  by  the  marks  of  the  corkscrew! 
It  was  thence  concluded  that   the  cork  had  been   forcibly 


POST-MORTEM    SIGNS   OF   SUFFOCATION.  145 

pushed  into  her  windpipe,  while  she  was  unable  to  resist, 
through  intoxication.  Another  case  of  homicidal  suffoca- 
tion is  related  (Woodman  and  Tidy's  Forcn.  Med.,  p.  851), 
of  a  Russian  sentry  on  guard,  being  found  dead  in  his 
watchbox,  with  a  large  piece  of  meat  in  the  lower  part  of 
the  pharynx,  pressing  upon,  and  partly  in  the  glottis.  His 
death  was  therefore  supposed  to  be  accidental.  Some  years 
after,  his  superior  officer,  in  dying,  confessed  that  he  had 
first  suffocated  the  man,  and  then  placed  the  piece  of  meat 
in  his  throat,  in  order  to  divert  suspicion  from  himself. 

Post-mortem  appearances. — Lividity  and  swelling  of  the 
face  and  lips,  though  often,  in  accidental  cases,  the  face  is 
placid;  the  eyes  are  congested;  minute  ecchymoses  on  the 
neck  and  chest;  mucous  froth,  sometimes  bloody,  about  the 
mouth  and  nose ;  the  lungs  and  right  side  of  the  heart  may 
be  gorged  with  dark  blood,  although  in  some  cases,  especially 
of  young  children,  the  lungs  may  be  empty  of  blood  and 
emphysematous.  Tardieu  lays  great  stress  upon  the  presence 
of  minute punctiform  ecchymoses,  especially  on  the  lungs  of 
new-born  infants,  who  have  been  suffocated.  These  spots 
are  also  found  on  the  pleura,  lining  membrane  of  the  heart, 
membranes  of  the  brain,  peritoneum,  and  mucous  lining  of 
the  windpipe.  Other  authorities,  among  whom  is  Dr. 
Ogston,  deny  that  these  extravasations  are  peculiar  to  cases 
of  suffocation,  as  they  are  found  in  other  modes  of  death. 
The  blood  is  dark  and  very  fluid.  The  kidneys  are  deeply 
congested. 

As  these  post-mortem  signs  are  also  found  in  other  forms 
of  death  by  apncea,  they  cannot  be  considered  as  character- 
istic of  death  by  suffocation.  Consequently,  the  examiner 
should  be  cautious  in  expressing  his  opinion  as  to  the  cause 
of  death.  If  a  dead  body  be  discovered  in  sand,  earth,  ashes, 
or  similar  substances,  the  question  whether  it  was  placed 


146  MEDICAL   JURISPRUDENCE. 

there  before  or  after  death  must  be  decided  by  a  careful 
examination.  If  the  substances  be  found  in  the  air  passages, 
and  especially  in  the  oesophagus  and  stomach,  it  may  bo 
concluded  that  the  person  was  alive  at  the  time. 

SECTION  II. 

DEATH  BY  STRANGULATION. 

MODES  OF  STRANGULATION. — EXTERNAL  SIGNS. — INTERNAL  LESIONS. 
— ACCIDENTAL,  SUICIDAL  AND  HOMICIDAL  STR  YNGULATION.— MARK 
OF   THE   CORD. 

Strangulation  is  produced  either  by  pressure  upon  the 
neck  by  means  of  an  encircling  cord,  or  by  direct  pressure 
made  by  the  hand  on  the  windpipe,  as  in  throttling.  The 
means  by  which  the  constriction  is  produced  are  various : 
sometimes  a  rope  is  used,  sometimes  a  strap,  a  handker- 
chief, a  ribbon,  or  a  strip  torn  from  a  sheet  or  the  clothing. 
In  Spain,  the  usual  mode  of  execution  of  criminals  is  by  the 
garrotte — a  steel  collar  tightened  by  a  screw;  in  Turkey,  it 
is  by  the  bow  string.  Death  results,  in  most  cases,  from  the 
combined  effect  of  the  deprivation  of  atmospheric  air,  pro- 
ducing apnoea,  and  from  congestion  of  the  brain,  due  to  the 
pressure  upon  the  jugulars,  preventing  a  return  of  blood 
from  the  brain.  It  differs  from  hanging  chiefly  in  the 
obliquity  of  the  cord  around  the  neck  in  the  latter,  while 
in  strangulation,  the  cord  is  wound  horizontally  around  the 
neck.  It  is  important,  medico-legally,  to  distinguish  be- 
tween death  from  strangulation  and  death  from  hanging,  as 
the  former  is  nearly  always  the  result  of  homicide,  while 
the  latter  is  usually  to  be  traced  to  suicide.  The  first  ques- 
tion that  presents  itself  here  is — was  the  death  caused  by 
strangulation?  The  appearances  of  one  strangled  are  usu- 
ally very  distinctly  marked :   these  are   livid  and  swollen 


SIGNS    OF    STRANGULATION.  147 

face ;  staring  eyes,  with  dilated  pupils,  and  protruding 
tongue,  which  may  be  bitten ;  livid  extremities ;  flattened 
larynx ;  blood  may  issue  from  the  nose,  mouth,  or  even 
ears;  the  face,  neck,  chest  and  eyes  are  studded  with  ecchy- 
moses  ;  the  genital  organs  frequently  turgid  ;  and  there  may 
be  an  escape  of  urine  and  faeces,  as  in  hanging.  Internally, 
the  right  heart  and  venous  system  are  sometimes  gorged 
with  blood ;  but  this  is  less  frequent  than  in  other  forms  of 
death  from  apnoea ;  this  is  also  true  of  the  congestion  of  the 
liver  and  kidneys.  Tardieu  states  that  the  lungs  are  seldom 
very  full  of  blood,  but  he  places  great  reliance  upon  the 
emphysematous  appearance  of  these  organs,  arising  from  a 
rupture  of  the  pulmonary  vesicles.  The  sub-pleural  ecchy- 
moses,  which  he  regards  as  characteristic  of  suffocation, 
he  says  are  rare  in  strangulation.  There  are  also  extrava- 
sations of  blood  in  the  lungs,  but  none  in  the  brain,  whereby 
it  is  distinguished  from  apoplexy,  which  it  resembles  in  a 
few  of  its  symptoms. 

Among  the  external  signs,  the  marks  of  the  cord,  and  of 
the  fingers  on  the  neck  deserve  special  attention.  These 
are  more  evident  and  reliable  here  than  in  hanging,  because 
in  homicidal  strangulation  very  considerable  force  is  gener- 
ally employed  by  the  murderer,  in  order  to  accomplish  his 
object.  If  the  hand  has  been  used,  as  in  throttling,  the 
marks  of  the  fingers  will  be  found  upon  the  front  of  the 
throat,  sometimes  of  two  or  more  fingers  and  the  thumb,  so 
that  the  particular  hand  employed  may  even  be  determined. 
If  a  cord  has  been  used,  the  mark  will  be  horizontal,  not 
oblique,  as  in  hanging ;  sometimes  there  may  be  two  or 
three  parallel  marks,  where  the  cord  has  been  wound  around 
the  neck  several  times.  The  mark  of  the  cord  is  apt  to  be 
less  deep  than  in  hanging,  and  subcutaneous  extravasation 
is  not  always  found ;  but  the  parts  beneath  may  show  con- 


148  MEDICAL   JURISPRUDENCE. 

siderable  infiltration  of  blood.  Fractures  of  the  hyoid  bone, 
and  of  the  ossified  thyroid  cartilages  are  reported  as  having 
occurred.  The  interior  of  the  larynx  and  trachea  is  con- 
gested, of  a  uniform  red  or  violet  color,  and  is  coated  over 
with  a  frothy,  bloody  mucus,  which  extends  also  into  the 
smaller  air  tubes.  This  internal  discoloration  of  the  wind- 
pipe should  not  be  mistaken  for  the  early  signs  of  putrefac- 
tion of  this  organ  (  Vid.  ante,  p.  4.7). 

The  mark  of  the  cord  around  the  neck  may  unquestion- 
ably be  produced  on  the  dead  body,  if  the  attempt  is  made 
within  a  few  hours  after  death,  and  while  the  body  is  still 
warm,  but  not  (according  to  Casper)  after  six  hours.  There- 
fore, this  one  particular  sign  should  never  be  relied  on  to 
the  exclusion  of  the  other  characteristic  evidences  of  death 
by  strangulation,  such  as  the  livid,  swollen  countenance,  the 
protruded  tongue,  the  staring  eyeballs,  etc.,  none  of  which 
arc  produced  by  strangulation  after  death.  Hence,  although 
a  murderer  may  place  a  cord  around  the  neck  of  his  dead 
victim,  with  a  view  to  make  the  case  simulate  a  suicide, 
there  will  be  little  difficulty  in  detecting  the  ruse. 

Was  the  straugli/ig  accidental,  suicidal  or  homicidal  ?  Cases 
of  accidental  strangulation  not  unfrequently  occur.  Prof. 
Taylor  records  two  :  one,  of  a  girl  carrying  fish  in  a  basket, 
which  was  strapped  around  the  upper  part  of  her  chest  in 
front.  She  was  found  dead,  sitting  on  a  stone  wall.  The 
basket  had  probably  slipped  off  while  she  was  resting,  and 
had  thus  raised  the  strap,  which  firmly  and  fatally  com- 
pressed the  trachea.  The  other  case  was  that  of  a  boy, 
whose  silk  necktie,  knotted  and  tightly  twisted  around  his 
neck,  was  caught  in  the  band  of  an  engine,  and  his  neck- 
drawn  down  against  one  of  the  revolving  shafts.  He  was 
rescued  after  his  neck  had  been  compressed  at  least  one 
minute.     He  became  black  in  the  face,  and  blood  escaped 


SUICIDAL   STRANGULATION.  1  19 

from  the  mouth  and  ears.  For  several  minutes  after  the 
removal  of  the  ligature,  he  was  insensible,  but  ultimately 
recovered.  Another  instance  is  related  by  Dr.  Gordon 
Smith,  of  a  lad  who  used  to  carry  a  heavy  weight  sus- 
pended from  his  neck  by  a  string.  One  day  he  was  found 
quite  dead,  sitting  in  a  chair.  He  had  probably  gone  to 
sleep,  the  weight  had  slipped,  and  drawn  the  cord  tight 
around  his  neck. 

Suicidal  strangulation  is  comparatively  rare,  except  among 
the  insane,  with  whom  it  is  by  no  means  uncommon.  The 
facility  of  effecting  their  purpose  by  such  simple  means  as 
a  garter,  a  ribbon,  a  handkerchief,  or  a  strip  torn  from  a 
garment,  may  readily  account  for  such  occurrences,  and 
still  further,  when  it  is  remembered  how  very  rapidly  and 
insidiously  unconsciousness  steals  over  the  senses  under  a 
pressure  of  the  windpipe,  thereby  taking  away  from  the  in- 
dividual the  will  and  the  power  to  escape.  A  case  men- 
tioned by  Dr.  Taylor  (Med.  Jurisp)  will  illustrate  this.  An 
insane  gentleman,  with  suicidal  tendencies,  was  placed  in  a 
private  asylum,  with  especial  directions  to  watch  him  closely, 
to  prevent  his  taking  his  life.  Two  attendants  were  placed 
over  him.  On  retiring  to  his  bed,  these  attendants  remained 
at  his  bedside ;  but  on  his  requesting  them  to  retire  to  a 
little  distance,  they  complied,  still  keeping  a  close  watch 
upon  him.  Two  hours  afterward,  the  physician,  on  visiting 
the  patient,  was  informed  by  the  attendants  that  he  had  been 
sleeping  quietly  for  some  time.  On  approaching  the  bed, 
to  their  horror  and  surprise,  they  found  the  gentleman 
dead !  He  had  strangled  himself  simply  by  tearing  off  a 
strip  from  the  bottom  of  his  shirt,  rolled  it  into  a  cord,  and 
tied  it  around  his  neck.  Other  cases  of  strangulation  are 
recorded  of  determined  suicides,  where  the  cord  was  found 
coiled  around  the  neck  several  times ;  in  one  instance,  the 


150  MEDICAL    JURISPRUDENCE. 

ligature  had  been  tightened  by  a  stick  thrust  in  and  twisted 
like  a  tourniquet;  and  in  still  another,  a  sabre  had  been 
used  for  the  same  purpose. 

Homicidal  strangulation,  as  already  mentioned,  is  the 
most  frequent  variety  of  this  form  of  violent  death.  It  is 
usually  recognized  by  the  marks  upon  the  neck  and  else- 
where, indicating  a  greater  amount  of  violence  employed. 
Thus,  the  impression  of  the  ligature  on  the  neck  will  be 
deeper  and  more  ecchymosed  than  occurs  in  a  suicide ;  it 
may  also  be  accompanied  by  the  marks  of  the  fingers  on 
the  throat,  which  latter  are  never  found  either  in  a  suicidal 
or  accidental  case.  Besides  these,  there  will  frequently  be 
seen  contusions  or  injuries  of  other  parts  of  the  body,  and 
other  evidences  of  a  struggle. 

It  should  not  be  forgotten  that  the  marks  of  homicidal 
strangulation  may  often  be  discovered  many  weeks,  or  even 
years,  after  burial.  One  is  mentioned  by  Wharton  and 
Stille  (Med.Jurisp.,  vol.  II,  p.  830),  where,  after  thirty-eight 
days'  interment,  the  evidence  of  strangulation  was  obtained 
chiefly  from  the  striking  contrast  of  the  integuments  of  the 
neck  with  those  of  the  rest  of  the  body.  There  was  a  white, 
shriveled  space  over  the  larynx,  half  an  inch  broad ;  also  a 
groove  around  the  neck,  of  a  blackish-brown  color  and 
parchment-like  appearance ;  this  condensed  skin  was  diffi- 
cult to  cut,  and  its  section  was  perfectly  dry  and  yellowish- 
white.  Another  remarkable  case  occurred  in  Paris,  where 
the  body  had  been  buried  several  years,  and  was  reduced 
almost  to  a  perfect  skeleton.  Several  of  the  cervical  verte- 
brae, together  with  the  right  clavicle,  were  found  held 
together  by  a  blackish  mass,  in  the  composition  of  which 
no  tissue  could  be  recognized.  This  mass  was  surrounded 
by  several  twists  of  a  cord  two  lines  in  diameter.  The  cord 
was  much  decayed,  showing  no  knots,  and  its  direction  was 


HANGING.  151 

horizontal.  The  above  facts  enabled  Orfila  and  other  medi- 
cal jurists  to  decide  that  the  woman  had  perished  by  stran- 
gulation. 

SECTION  III. 
DEATH  BY  HANGING. 

CAUSE     OF     DEATH     IN      HANGING. — POST-MORTEM     APPEARANCES. — 
CORD-MARK. — GENERALLY   SUICIDAL. 

Hanging  is  that  mode  of  death  caused  by  suspension  of 
the  body  by  the  neck,  the  weight  of  the  body  acting  as  the 
constricting  force.  Physiologically,  it  is  the  same  as  stran- 
gulation, and,  like  the  latter,  the  cause  of  death  is  partly 
apncea  and  partly  cerebral  congestion,  and  more  frequently 
a  combination  of  the  two.  The  following  table  exhibits  the 
relative  frequency  of  each  form  of  death  : — 


Apoplexy, 
Asphyxia  (Apncea), 
Mixed, 


emer. 

Casper. 

9 

9 

6 

14 

68 

62 

S3  s5 

If  the  cord  encircles  the  neck  below  the  thyroid  cartilage, 
the  death  is  more  rapid,  and  is  to  be  ascribed  to  apncea;  but 
if  higher  up,  as  in  executions,  where  it  is  apt  to  slip  under 
the  chin,  some  little  space  on  either  side  may  escape  con- 
striction, so  as  to  admit  a  slight  amount  of  air  into  the 
lungs ;  in  this  case  the  death  will  be  slower,  and  be  due 
rather  to  cerebral  congestion.  In  the  great  majority  of 
cases,  however,  as  shown  by  the  above  table,  the  cause  of 
death  is  of  a  mixed  nature.  In  some  cases  of  public  execu- 
tions, where  the  fall  was  very  considerable,  and  where  a 
violent  rotary  swing  was  given  to  the  body  of  the  criminal 
at  the  moment  of  the  drop,  the  odontoid  process  of  the 
second  cervical  vertebra  has  been  found  either  fractured  or 
dislocated,  causing  immediate  death,  owing  to  pressure  on 
the  spinal  cord.    But  death,  in  hanging,  from  fracture  of  the 


152  MEDICAL    JURISPRUDENCE. 

vertebrae,  is  far  less  frequent  than  is  popularly  imagined. 
Orfila  states  that  in  the  bodies  of  fifty  persons  who  had 
been  hanged  he  met  with  a  fracture  of  the  os  hyoides  in 
only  one  case,  while  he  had  never  met  with  a  fracture  or 
luxation  of  the  vertebrae. 

There  is  reason  to  believe  that  death  by  hanging  is  nearly 
painless.  The  convulsive  movements  of  the  limbs,  as  is 
well-known,  are  no  indications  of  suffering.  Unconscious- 
ness very  speedily  supervenes,  especially  if  the  trachea  is 
compressed,  and  death  occurs  in  a  very  few  minutes.  Per- 
sons who  have  been  cut  down  after  a  few  minutes'  suspension 
are  very  rarely  resuscitated.  And  even  after  an  apparent 
partial  recovery,  death  often  follows  from  secondary  effects, 
especially  from  congestion  of  the  brain. 

The  insidious  manner  in  which  the  loss  of  consciousness 
steals  upon  the  brain  in  hanging  deserves  especial  notice, 
because  it  satisfactorily  explains  the  facility  with  which 
death  takes  place,  even  when  the  suspension  of  the  body  is 
not  complete,  but  when  there  has  been  simply  a  pressure 
of  the  ligature  against  the  windpipe,  the  person  meanwhile 
resting  on  the  knees  or  toes,  or  being  in  a  semi-recumbent 
posture. 

Post-mortem  appearances. — In  the  main,  they  resemble 
those  attending  death  from  strangulation.  Externally,  swell- 
ing and  lividity  of  face,  congestion  of  the  eyelids,  dilated 
pupils,  eyes  red  and  protruding,  tongue  swollen,  livid,  often 
protruded  or  compressed  between  the  teeth,  lower  jaw 
retracted,  often  a  bloody  froth  escaping  from  the  mouth  and 
nostrils.  In  addition,  there  are  often  petechial  effusions  on 
the  neck,  shoulders,  arms  and  hands.  In  many  cases,  how- 
ever, the  countenance  is  calm,  the  face  pale,  the  eyes  and 
tongue  natural.  Sometimes  there  is  turgescence  of  the 
genital   organs,  with  an   involuntary   escape   of  the   urine, 


SIGNS    OF    HANGING.  153 

faeces  and  semen;  but  these  signs  are  by  no  means  peculiar 
to    death  by  hanging.     The   position   of  the  head  varies 
according  to  the  part   of  the   neck  where  the   knot  was 
placed.     As  the  latter  is  usually  behind  the  neck,  the  head 
is  generally  flexed  forward.     If  the  knot  were  in  front,  the 
head  would  be  found  extended  backward  (Tardieu).     The 
hands  are  generally  closed,  often  tightly  ;  the  legs  extended, 
and  often  livid.    The  neck  is  nearly  always  stretched,  owing 
to  the  weight  of  the  body,  and   it  presents  very  decided 
marks  of  the  cord,  varying  however   somewhat,  according 
to  the  nature  of  the   latter  and   its   mode  of   application. 
Thus,  the  mark  maybe  deep  or  superficial,  single  or  double, 
according  to  the   strain    made  upon  it,  and  its   thickness, 
roughness,  or  duplication.     The  skin  under  this  mark  be- 
comes very  dense  and  tough,  and  of  a  yellowish-brown 
color,  and  has  been  aptly  compared  to  old  parchment.    This 
appearance  is  more  marked  some  hours  after  death,  if  the 
cord  has  been  removed  ;  and  the  cellular  tissue  underneath 
is  also  condensed,  and  has  a  silvery  appearance.     Besides 
the  above,  there  is   often  a  livid  mark  (ecchymosis),  where 
great  violence   has  been   used,  as   in  executions ;  but  the 
latter  is  quite  distinct  from  the  true  mark  of  the  cord,  with 
which  it  has  been  confounded.     The  livid  line  is  much  less 
frequently  met  with  than  was  formerly  supposed. 

The  groove  or  furrow  in  the  neck,  in  the  great  majority 
of  cases,  will  be  found  between  the  chin  and  larynx ;  its 
direction  is  oblique  (which  distinguishes  it  from  strangula- 
tion) ;  it  may  also  be  double  (arising  from  a  double  fold  of 
the  cord),  and  irregular  or  interrupted.  In  general,  the 
narrower  the  ligature,  and  the  longer  the  suspension,  the 
deeper  the  furrow.  A  broad  leather  thong,  pressing  only 
by  its  borders,  might  produce  a  double  mark. 

Internally,    the    appearances    usually  accompanying  as- 
8 


154  MEDICAL   JURISPRUDENCE. 

phyxia  arc  met  with,  such  as  engorgement  of  the  lungs, 
right  side  of  the  heart,  and  venous  system  with  dark  fluid 
blood.  The  lining  membrane  of  the  larynx  and  trachea  is 
deeply  congested,  as  in  strangulation,  and  is  sometimes 
coated  with  a  bloody  froth.  The  vessels  of  the  brain  are 
generally  congested,  but  extravasation  of  blood  into  the 
brain,  or  upon  its  membranes  is  extremely  rare.  The  brain 
itself,  when  cut  into,  presents  numerous  bloody  points.  The 
kidneys  are  usually  congested  ;  the  stomach  frequently  pre- 
sents evidences  of  such  deep  congestion  as  to  suggest  the 
idea  of  an  irritant  poison.  The  same  is  true  also  of  the 
intestines.  Dr.  Yellowly  has  found  coagulated  blood  on 
the  mucous  membrane  of  the  stomach,  in  two  out  of  every 
five  cases  of  death  by  hanging. 

Among  the  occasional  lesions  may  be  mentioned  fracture 
of  the  hyoid  bone  and  thyroid  cartilage,  and  rupture  of  the 
internal  and  middle  coats  of  the  common  carotid  arteiy. 
According  to  Dr.  Dyer  (Nezv  York  Med.  Jour.,  1866),  a 
transverse  fracture  of  the  crystalline  lens  is  a  frequent  result 
of  death  by  hanging.  He  discovered  it  in  three  cases  out 
of  four,  one  of  a  man,  and  three  of  dogs.  Some  years  ago 
these  experiments  on  dogs  and  cats  were  repeated  by  one 
of  the  author's  students,  at  the  University  of  Pennsylvania, 
but  in  every  instance  with  a  negative  result. 

An  important  medico-legal  question  to  settle  is — zvas  the 
death  caused  by  hanging  ?  This  cannot  always  be  satisfac- 
torily determined  by  mere  medical  evidence,  since  there  are 
no  positive  or  characteristic  signs  of  this  kind  of  death. 
The  mere  suspension  of  the  body  is  no  proof,  since  a  mur- 
derer might  easily  suspend  the  body  of  his  victim,  in  order 
to  divert  suspicion  from  the  true  cause  of  death.  The  mark 
of  the  cord  can  be  imitated  by  suspending  a  dead  body  by 
the  neck  immediately  after  death,  and,  according  to  Casper, 


HANGING SUICIDAL,  HOMICIDAL   OR    ACCIDENTAL?     155 

even  up  to  seventy-two  hours  after,  especially  if  the  body 
be  forcibly  pulled  downward.  The  livid  or  ecchymosed  line 
is  less  likely  to  be  found,  under  these  circumstances,  than  the 
brownish,  parchment-like  furrow.  Hence,  it  follows  that  the 
mark  of  the  cord  cannot  be  regarded  as  evidence  of  death 
by  hanging ;  and  the  other  usual  signs,  such  as  turgescence 
and  lividity  of  the  face,  congested  eyes,  swollen  tongue,  etc., 
are  all  met  with  in  strangling,  and  other  forms  of  death, 
while  these  very  signs  may  be  absent  in  certain  cases  of 
hanging.  Dr.  R.  F.  Hutchinson  states  that  an  invariable 
sign  of  death  from  hanging  is  the  flow  of  saliva  out  of  tlie 
mouth,  down  the  chin,  and  straight  down  the  chest.  The 
appearance  is  unmistakable  and  invariable,  and  could  not 
occur  in  a  body  hung  up  after  death,  the  secretion  of  saliva 
being  a  living  act  (Chevers,  quoted  by  Husband). 

To  determine  the  question  whether  the  hanging  was  sui- 
cidal, homicidal  or  accidental,  regard  must  be  had  to  the 
attending  circumstances;  remembering  always  that  hanging 
is  a  particularly  frequent  method  of  suicide.  Out  of  368 
cases  of  suicide  occurring  in  Berlin,  189  resulted  from 
hanging.  Hence,  the  presumption  is  always  in  favor  of 
suicide;  besides  the  difficulties  that  would  attend  an  attempt 
at  murder  by  this  means.  If,  however,  the  body  exhibit 
evidences  of  great  violence  externally,  denoting  a  struggle, 
or  marks  of  the  fingers  about  the  throat,  or  of  internal 
laceration,  these  would  be  more  consistent  with  homicide. 
The  position  of  the  body  will  throw  very  little  light  upon  the 
question,  since  it  is  fully  demonstrated  that  complete  suspen- 
sion is  not  necessary  to  produce  death.  In  numerous 
instances  the  body  has  been  found,  after  death,  resting  upon 
the  knees,  the  toes,  or  the  buttocks,  or  semi-recumbent,  and 
in  one  case  entirely  supported  by  the  bedstead,  while  the 
neck  rested  in  a  loop  of  leather. 


15G  MEDICAL   JURISPRUDENCE. 

Even  if  the  hands  and  feet  are  found  tied,  the  inference 
is  not  warranted  that  the  act  was  homicidal,  since  deter- 
mined suicides  have  been  known  to  perform  this  very  act 
previous  to  hanging  themselves.  Nevertheless,  if  a  person 
be  found  with  his  hands  and  feet  tied,  and  suspended  from 
a  position  which  obviously  he  could  not  have  reached 
himself,  the  presumption  of  homicide  would  certainly  be 
justified. 

The  age  of  the  deceased  might  be  supposed  to  assist  in 
solving  the  question.  If  a  very  young  person  were  discov- 
ered dead  from  hanging,  it  would  naturally  be  attributed  to 
homicide ;  yet  numerous  instances  have  occurred  in  this 
country,  within  the  last  few  years,  of  suicidal  hanging  of 
children  not  over  twelve  or  fourteen  years  of  age. 

Cases  of  accidental  hanging  are  of  occasional  occurrence, 
especially  among  children,  who  have,  while  swinging,  or 
otherwise  playing,  accidentally  become  entangled  in  a  noose 
or  loop  of  cord,  which  was  then  drawn  tightly  enough 
around  the  neck  to  strangle  them. 

SECTION    IV. 
DEATH  BY  DROWNING. 

MODE  OF  DEATH  IN  DROWNING. — TIME  REQUIRED. — SIGNS  OF  DEATH, 
EXTERNAL  AND  INTERNAL. — ACCIDENTAL,  SUICIDAL  AND  HOMI- 
CIDAL  DROWNING. 

Drowning  is  that  special  form  of  death  by  suffocation,  in 
which  the  breathing  is  arrested  by  water,  or  some  other 
liquid,  and  even  more  effectually  than  by  a  ligature  drawn 
around  the  neck.  It  is  not  necessary  that  the  whole  body 
should  be  submerged  in  order  to  cause  death  by  drowning. 
This  may  be  accomplished  by  merely  immersing  the  face,  so 
as  to  keep  the  nose  and  mouth  under  the  liquid,  as  is  wit- 


DROWNING.  157 

nessed  in  the  case  of  drunkards,  epileptics  and  very  young 
children  falling  with  their  faces  into  very  shallow  pools,  and 
perishing  from  inability  to  extricate  themselves.  In  drown- 
ing, in  addition  to  the  usual  cause  of  death  by  asphyxia — 
the  deprivation  of  air — there  is  superadded  the  physical 
impediment  of  the  introduction  of  water  into  the  minute  air 
tubes  and  vesicles  of  the  lungs  by  aspiration,  in  the  violent 
efforts  of  the  person  to  breathe.  This  is  demonstrated  by 
the  experiments  made  by  the  Committee  of  the  Medico- 
Chirurgical  Society  of  London.  Two  dogs  of  the  same 
size  were  submerged  at  the  same  moment,  but  one  had  his 
windpipe  plugged,  so  as  to  prevent  the  ingress  of  both  air 
and  water,  while  the  other  had  not.  After  two  minutes  they 
were  taken  out  together ;  the  one  with  the  windpipe  plugged 
recovered  at  once  on  removing  the  plug;  the  other  died. 
In  three  experiments,  dogs  with  their  windpipes  plugged 
were  kept  under  water/#?/r  minutes,  and  recovered  perfectly 
on  being  taken  out  (Report  on  Suspended  Animation,  Med. 
Chir.  Trans.,  1862,  p.  449).  On  inspecting  the  bodies  of  the 
animals,  the  difference  was  at  once  manifest;  in  those  that 
were  simply  deprived  of  air  by  plugging  the  windpipe,  the 
lungs  were  congested  ;  but  in  those  that  had  been  sub- 
merged in  their  ordinary  condition,  i.  e.  actually  drowned, 
the  lungs,  besides  being  congested,  exhibited  in  their  bron- 
chial tubes  and  air  vesicles  a  bloody,  frothy  mucus,  which 
completely  filled  the  air  vesicles  and  small  tubes,  forming  a 
mechanical  impediment  to  the  ingress  or  egress  of  air.  The 
lungs  were  sodden  with  water,  heavy,  soft  and  doughy  to 
the  feel,  and  pitted  on  pressure  of  the  finger.  In  the  lungs 
of  animals  that  recovered  after  a  short  submersion,  very 
little,  if  any,  of  this  mucous  froth  was  found ;  its  amount 
was  always  proportionate  to  the  time  of  submersion.  There 
is   no    doubt   that   this    froth   is  produced  by  the  violent 


158  MEDICAL   JURISPRUDENCE. 

efforts  to  breathe  which  are   made  within  a  minute  after 
submersion. 

Hence,  the  probability  of  recovery  after  drowning  is 
mainly  dependent  upon  the  quantity  of  this  mucous  froth 
existing  in  the  air  tubes  and  vesicles  of  the  lungs,  and  also 
of  the  water  that  has  penetrated  into  the  substance  of  the 
lungs.  If  the  quantity  is  large,  the  result  is  almost  certainly 
fatal ;  if  it  is  small,  there  is  always  good  hope  of  recovery. 
Asphyxia  occurs  in  a  minute,  to  a  minute  and  a  half  after 
submersion.  If  the  submersion  has  been  complete  for  four 
minutes,  the  case  may  be  considered  hopeless,  unless  syn- 
cope had  occurred  at  the  moment  of  entering  the  water. 
This,  by  partially  suspending  the  attempts  at  respiration, 
would  undoubtedly  tend  to  prolong  life  for  some  minutes 
longer.  Cases  are  reported  of  resuscitation  after  being 
fifteen  minutes  under  water;  but  these  are  exceptional.  It 
should  be  remembered  that  the  heart  may  continue  to  beat 
some  minutes  after  respiration  has  ceased;  but,  in  the 
present  instance,  the  pulsation  of  the  heart  is  no  criterion  of 
the  power  of  recover}-,  on  account  of  the  physical  impedi- 
ment in  the  lungs  just  alluded  to. 

Dr.  Tavlor  gives  the  following  excellent  resume  of  the 
circumstances  attending  on  a  case  of  drowning:  "When  a 
person  falls  into  the  water  and  retains  his  consciousness, 
violent  attempts  are  made  to  breathe;  at  each  time  that  he 
rises  to  the  surface  a  portion  of  air  is  received  into  the 
lungs,  but,  owing  to  the  mouth  being  on  a  level  with  the 
liquid,  water  also  enters  and  passes  into  the  throat.  A 
quantity  of  water  thus  usually  enters  the  mouth,  which  the 
drowning  person  is  irresistibly  compelled  to  swallow.  In 
his  efforts  to  breathe  while  his  head  is  below  the  water,  a 
portion  of  this  liquid  is  drawn  into  the  air-tubes  and  cells 
of  the  lungs.     The  struggle   for   life  may  continue   for  a 


SIGNS   OF    DROWNING.  159 

longer  or  shorter  period,  according  to  the  age,  sex  and 
strength  of  the  person,  but  the  result  is  that  the  blood  in 
the  lungs  is  imperfectly  aerated,  the  person  becomes  ex- 
hausted, and  insensibility  follows.  The  mouth  then  sinks 
altogether  below  the  level  of  the  water ;  air  can  no  longer 
enter  into  the  lungs  ;  a  portion  of  that  which  they  contained 
is  expelled,  and  rises  in  bubbles  to  the  surface ;  an  inde- 
scribable feeling  of  delirium,  with  a  ringing  sensation  in  the 
ears,  supervenes ;  the  person  loses  all  consciousness,  and 
sinks  asphyxiated.  In  the  state  of  asphyxia,  while  the 
dark -colored  blood  is  circulating,  convulsive  movements  of 
the  body  take  place,  and  the  contents  of  the  stomach  are 
sometimes  ejected  by  vomiting.  There  does  not  appear  to 
be  any  sensation  of  pain,  and,  as  in  the  other  cases  of 
asphyxia,  if  the  person  recovers,  there  is  a  total  uncon- 
sciousness of  any  suffering  "  (Med.  Jurisp.,  Am.  ed.,  p.  416). 

Even  after  resuscitation  from  drowning,  death  frequently 
takes  place  within  a  few  hours  or  days,  from  secondary 
causes,  as  exhaustion,  obstruction  to  respiration  from  the 
condition  of  the  lungs,  convulsions  and  spasm  of  the 
glottis. 

Signs  of  death  by  Drowning. — 1.  External.  These  vary, 
according  to  the  length  of  time  the  body  has  been  in  the 
water,  and  the  interval  after  it  was  taken  out.  Supposing 
the  immersion  not  to  have  been  over  two  or  three  hours, 
and  the  inspection  to  be  made  immediately,  the  face  will  be 
found  to  be  pale,  the  expression  placid,  the  eyes  half  open, 
the  eyelids  livid,  and  the  pupils  dilated,  the  mouth  half 
closed  or  open,  the  tongue  swollen  and  congested,  often 
indented  by  the  teeth,  and  perhaps  lacerated;  the  lips  and 
nostrils  covered  with  a  mucous  froth,  which  issues  from 
them.  The  skin  is  cold  and  pale,  and  generally  contracted 
so  as  to  present  the  appearance  of"  goose  skin  "  {cutis  anse- 


1  60  MEDICAL   JURISPRUDENCE. 

rind).  This,  being  a  vital  act,  is  a  pretty  sure  sign  that  the 
body  was  living  when  immersed  in  the  water.  It  is  not 
dependent  on  cold,  as  was  at  one  time  supposed.  In  males, 
the  retraction  of  the  penis  is  considered  by  Casper  and  Kanz- 
ler  as  a  very  positive  sign  of  drowning. 

Besides  the  above,  there  are  sometimes  seen  marks  of 
abrasion  on  the  body,  especially  on  the  hands,  together  with 
sand,  gravel  or  mud  under  the  nails,  weeds,  pieces  of  wood 
or  other  matters  locked  in  the  hands,  all  of  which  would 
seem  to  indicate  that  the  person  had  been  alive  when  first 
immersed  in  the  water,  although  the  abrasions  might  very 
possibly  have  resulted  from  the  body  rubbing  against  some 
rough  substances  after  death.  After  several  days'  immer- 
sion, the  palms  of  the  hands  and  soles  of  the  feet  become 
white,  thickened  and  sodden,  the  result  of  imbibition. 

If  putrefaction  has  commenced  before  the  body  is  removed 
from  the  water,  the  face  will  have  assumed  a  reddish,  or 
bluish-red  coloration. 

2.  Internal. — Along  with  the  usual  evidences  of  death 
from  asphyxia  (in  an  early  examination),  the  following  signs 
will  be  observed :  the  lungs  are  distended,  overlapping  the 
heart,  and  are  in  a  flabby  condition ;  this  latter  is  owing  to 
the  water  taken  in  by  aspiration,  during  the  struggles  for 
breath,  which  penetrates  even  the  air  vesicles,  and  renders 
them  sodden  and  doughy.  When  cut  into,  the  lungs  exude 
a  bloody,  mucous  froth.  The  presence  of  this  froth  in  the 
smaller  tubes  and  air  cells }  together  with  the  sodden  condition 
of  the  lungs,  is  regarded  as  one  of  the  most  positive  signs 
of  death  by  drowning.  Nevertheless,  its  absence  should 
not  be  accepted  as  a  proof  against  drowning,  since  it  has 
not  been  found  in  the  bodies  of  persons  who  have  sunk  at 
once  in  the  water,  and  never  risen  to  the  surface  to  breathe. 
Dr.  Ogston  states  that  in  48.7  per  cent,  of  cases,  no  water 


SIGNS    OF    DROWNING.  161 

was  found  in  the  lungs,  and  he  accounts  for  its  absence  by 
its  transudation  from  the  .lungs  into  the  pleural  cavities, 
where  it  was  found  in  quantities  varying  from  one  to  thirty- 
four  ounces.  In  a  case  examined  by  the  author  a  year  ago, 
of  the  body  of  a  woman  taken  out  of  the  river  Delaware, 
there  was  an  absence  of  this  characteristic  froth  in  the 
minute  bronchial  tubes,  and  also  of  the  peculiar  flabby  con- 
dition of  the  lungs.  The  absence  of  these  same  peculiari- 
ties in  the  lungs  of  the  deceased,  in  the  late  celebrated 
Jennie  Cramer  case,  at  New  Haven,  Ct.,  created  a  doubt  in 
the  minds  of  many  that  it  was  not  a  case  of  suicide  by 
drowning,  but  that  the  girl  was  murdered  before  the  body 
was  thrown  into  the  water.  The  fact  of  the  discovery  of  a 
considerable  amount  of  arsenic  in  the  body  of  the  deceased 
was,  of  course,  sufficient  to  account  for  the  death.  We 
believe  that  these  peculiar  conditions  of  the  lungs  of  the 
drowned  have  not  yet  been  sufficiently  determined.  It  is 
quite  possible  that  some  cases  of  bodies  taken  out  of  the 
water,  and  reported  by  coroners'  juries  as  "  found  drowned," 
may  in  reality  have  met  their  death  by  other  means,  prior  to 
their  immersion.  It  is  important  to  remember  that  the 
presence  of  this  mucous  froth  in  the  air-passages  is  not  seen 
after  putrefaction,  or  after  long  exposure  of  the  body  to  the 
air :  this  may  account  for  the  fact  of  its  occasional  non- 
observance  in  the  bodies  of  the  drowned. 

Another  important  indication  of  death  by  drowning  is  the 
presence  of  water  hi  the  stomach,  which  had  been  swallowed 
in  the  act  of  drowning,  especially  if  this  corresponds  with 
the  water  in  which  the  body  was  found.  The  value  of  this 
is  enhanced,  if,  along  with  the  water,  there  be  discovered  in 
the  stomach  fragments  of  weeds,  sand,  mud  or  other  articles, 
corresponding  with  the  like  substances  existing  in  the  pond 
or  river  where  the  drowning  occurred.  The  quantity  of 
8i: 


162  MEDICAL   JURISPRUDENCE. 

water  in  the  stomach  varies  considerably ;  it  was  found  to 
be  greater  in  an  animal  that  was  allowed  to  come  to  the 
surface  frequently,  than  in  one  kept  completely  submerged, 
because  in  the  latter  the  power  of  swallowing  was  sooner 
lost,  in  consequence  of  the  early  occurrence  of  asphyxia. 

The  absence  of  water  from  the  stomach  is  not  to  be  con- 
sidered as  disproving  a  case  of  drowning,  inasmuch  as  it  is 
not  present  (because  not  swallowed)  in  cases  where  either 
syncope  or  apoplexy  had  occurred  at  the  moment  of  im- 
mersion. 

The  mere  discovery  of  water  in  the  stomach  is  not  of 
itself  a  positive  indication  of  death  by  drowning,  since  it 
may  have  been  swallowed  before  immersion;  but  with  this 
allowance,  and  with  the  restrictions  above  mentioned,  it 
does  constitute  a  very  important  sign,  inasmuch  as  it  has 
been  ascertained  by  experiment  that  water  will  not  penetrate 
into  the  stomach  after  death,  unless  putrefaction  has  ad- 
vanced to  a  great  extent;  consequently,  its  presence  indi- 
cates pretty  certainly  that  it  had  been  swallowed  in  the  act 
of  drowning.  Orfila's  experiments  prove  that  water  may 
penetrate  into  the  larger  bronchial  tubes  after  death,  but  not 
into  the  air  vesicles  of  the  lungs;  besides,  in  such  cases, 
there  is  no  accompaniment  of  mucous  froth  in  the  air  tubes. 

The  condition  of  the  heart  affords  no  positive  indication 
of  death  by  drowning.  In  the  majority  of  cases  the  right 
cavities  are  full,  and  the  left  ones  empty,  as  in  asphyxia  gen- 
erally ;  but  very  often  the  two  sides  are  equally  full. 

The  brain  exhibits  no  characteristic  post-mortem  sign. 
There  may  be  some  general  fullness  of  the  vessels,  but 
never  extravasation  of  blood,  unless  a  sudden  apoplexy 
had  supervened,  as  when  a  person  plunges  suddenly  into 
cold  water  after  eating  heartily,  or  by  striking  the  head 
against  a  hard  body,  in  the  act  of  diving.    The  blood  is  usu- 


SIGNS    OF    DROWNING.  163 

ally  dark  and  fluid.  The  mucous  lining  of  the  stomach  and 
bowels  is  usually  congested,  and  if  the  body  had  been  long 
in  the  water,  of  a  deep  violet  color;  this  might  lead  to  the 
suspicion  of  irritant  poisoning.  Occasionally,  in  cases  of 
drowning  after  a  full  meal,  vomiting  occurs,  and  the  con- 
tents of  the  stomach  are  found  in  the  windpipe  and  lungs; 
this  is  a  conclusive  evidence  that  the  person  must  have  been 
alive  at  the  time. 

The  time  at  which  the  bodies  of  the  drowned  will  float 
varies  with  the  temperature  of  the  air,  the  water,  the  age, 
sex  and  corpulence  of  the  person,  etc.  As  the  human  body 
is  slightly  heavier  than  water,  it  must  remain  submerged 
until  it  becomes  lighter,  through  the  development  of  the 
gases  of  putrefaction.  Hence,  in  summer,  the  body  may 
rise  within  twenty-four  hours.  In  salt  water,  it  will  float 
sooner  than  in  fresh ;  very  fat  bodies  float  sooner  than  lean 
ones ;  the  bodies  of  women  sooner  than  those  of  men. 

To  determine  the  time  that  has  elapsed  since  the  act  of 
drowning,  when  the  body  is  discovered  in  the  water,  is  not 
always  possible.  After  putrefaction  has  set  in,  it  is  altogether 
mere  guesswork.  The  most  certain  criteria  to  guide  the 
examiner  are  the  presence  of  the  mucous  froth  in  the  air 
tubes  and  cells,  and  the  presence  of  water  in  the  lung  tissue, 
both  of  which  indications  disappear  after  long  exposure  to 
the  air,  and  after  putrefaction.  Hence,  the  importance  of  an 
early  inspection. 

If  marks  of  violence  be  found  on  the  bodies  of  the 
drowned,  of  course,  suspicion  will  be  aroused  of  foul  play, 
unless  these  marks  can  be  satisfactorily  attributed  to  some 
post-mortem  cause.  A  murderer  may  destroy  his  victim, 
and  then  throw  the  body  into  the  river,  pond,  or  well,  with 
the  intention  to  elude  suspicion  of  the  real  cause  of  death. 
A  close  examination  of  the  body  for  wounds,  and  other 


16  i  MEDICAL   JURISPRUDENCE. 

injuries,  together  with  the  absence  of  the  known  signs  of 
drowning,  will  generally  enable  the  examiner  to  form  a 
correct  conclusion.  This  is  a  very  common  method  of 
disposing  of  the  bodies  of  new-born  infants,  in  cases  of 
infanticide. 

The  question  of  accident,  homicide  or  suicide,  in  the  case 
of  drowning,  must  claim  the  attention  of  the  legal  physi- 
cian. Homicidal  drowning  is  rare,  except  in  the  case  of 
infants.  It  is  denoted  by  the  marks  of  violence  on  the 
bod\-,  which  cannot  be  explained  by  any  post-mortem  influ- 
ence. It  should  be  remembered  that  determined  suicides 
frequently  inflict  dangerous  wounds  upon  themselves,  and 
then  terminate  their  lives  by  drowning.  Such  cases  might 
possibly  be  mistaken  for  homicide.  The  presence  of  the 
usual  signs  of  drowning  would  at  least  show  that  the  body 
was  alive  at  the  time  of  immersion.  Suicidal  and  accidental 
drowning  cannot  always  be  distinguished  from  each  other; 
inferences  may,  however,  be  drawn  from  the  circumstances 
attending  the  cases,  as  the  existence  of  a  motive  to  suicide, 
or  a  tendency  thereto;  the  proximity  of  a  precipice,  or  other 
dangerous  place,  to  the  water  in  which  the  deceased  was 
found  would  naturally  suggest  accident,  especially  in  the 
case  of  a  child.  The  tying  of  the  hands  and  feet  of  a  per- 
son found  dead  in  the  water  is  no  proof  of  homicide,  since 
many  instances  are  recorded  of  suicides  binding  themselves 
in  this  same  manner,  and  also  of  attaching  heavy  weights 
to  their  bodies  before  throwing  themselves  into  the  water. 

Tlie  restoration  of  the  drowned  depends  chiefly  on  exciting 
artificial  respiration.  The  clothes  should  be  immediately 
removed,  and  the  body  quickly  wiped  dry  and  wrapped  in  a 
blanket;  clear  the  mouth  and  nostrils  of  mucus  and  water; 
draw  forward  the  tongue ;  place  the  body  with  the  face  down- 
ward, the  forehead  resting  on  one  arm,  for  a  few  moment-, 


RESUSCITATION    OF    THE    DROWNED.  165 

to  allow  the  fluids  to  run  out  of  the  mouth;  apply  ammonia 
cautiously  to  the  nose.  If  respiration  is  not  restored,  place 
the  body  on  the  back,  with  the  head  raised,  and  adopt  Syl- 
vester's process  of  artificial  respiration,  by  carrying  the  arms 
gently  outward  and  upward  above  the  head,  for  a  few 
seconds :  this  movement  expands  the  chest.  Then  lower 
the  arms,  and  bring  them  to  the  sides  of  the  chest :  by  this 
action,  expiration  is  effected.  These  alternate  movements 
should  be  made  each  about  every  two  seconds.  All  rough 
handling,  such  as  the  absurd,  vulgar  plan  of  rolling  on  a 
barrel,  should  be  avoided.  As  soon  as  any  signs  of  respira- 
tion are  manifested,  warmth  should  be  applied  to  the  skin 
by  a  warm  bath,  or  stimulating  friction.  When  able  to 
swallow,  the  patient  may  take  a  little  warm  spirit  and  water, 
and  then  be  put  to  bed  and  allowed  to  sleep.  This  treat 
ment  has  been  rewarded  with  success  after  being  persisted 
in  for  some  hours. 


1G6  MEDICAL   JURISPRUDENCE. 


CHAPTER   X. 

DEATH  BY  LIGHTNING. 

MEDICO-LEGAL   RELATIONS   OF   DEATH   FROM    LIGHTNING. — MODE   OF 
DEATH. — POST-MORTEM    SIGNS. 

Death  caused  by  Lightning  is  often  accompanied  by 
results  which  resemble  very  strongly  the  effects  of  homi- 
cidal violence.  The  subject  should,  therefore,  claim  the 
attention  of  the  legal  physician,  inasmuch  as  he  may  be 
called  upon  to  determine  the  cause  of  death  in  an  un- 
known case,  when  the  body  has  been  discovered  in  a 
remote  and  solitary  situation,  and  bearing  upon  it  marks 
of  severe  external  injury. 

The  destructive  effects  of  lightning  exactly  resemble 
those  of  a  powerful  electric  battery,  thus  demonstrating  the 
identity  of  the  two  forces.  In  a  thunder-storm  the  electric 
condition  or  polarity  of  the  cloud  is  nearly  always  positive, 
while  that  of  the  earth  immediately  beneath  it  is  negative* 
When  these  polarities  become  intensified  by  mutual  induc- 
tion, the  disruptive  discharge  ensues  through  the  air,  or  any 
other  body  that  may  happen  to  intervene — the  human  body, 
for  example. 

The  only  rational  explanation  of  the  fact  that  more  men 
than  women  are  killed  by  lightning  is,  that  the  former,  from 
the  nature  of  their  employments,  are  mostly  out  of  doors, 
and  are,  therefore,  more  exposed  to  the  danger.  Experi- 
ence proves  that  persons  in  the  open  fields,  especially  under 
trees,  are  much  more  liable  to  be  struck  by  lightning  than 
those  within  doors. 

The  fatal  effects  of  lightning  are   usually  instantaneous, 


DEATH    BY    LIGHTNING.  167 

death  being  caused  by  shock.  At  times,  however,  it  pro- 
duces lesions  of  the  brain  and  spinal  cord,  such  as  epilepsy, 
paralysis,  effusion  of  blood,  tetanus,  etc.,  which  may  subse- 
quently prove  fatal.  Generally  speaking,  if  death  does  not 
follow  immediately,  or  soon  after,  there  may  be  hopes  of 
recovery. 

The  visible  effects  produced  by  a  fatal  lightning-stroke 
are  remarkably  varied.  Sometimes,  a  deep,  punctured  or 
lacerated  wound  will  indicate  where  the  fatal  blow  was 
struck,  upon  the  head,  neck,  or  other  part  of  the  body ;  the 
hair  may  be  singed,  or  burnt  off;  the  clothing  may  be  burned, 
or  completely  stripped  off;  the  boot  may  be  split  open. 
Again,  the  course  of  the  electric  current  may  be  marked 
by  a  deep,  or  superficial  burn,  extending  from  the  point  of 
entrance,  down  and  around  the  body,  to  the  ground.  If 
there  should  happen  to  be  any  metallic  substances  in  con- 
tact with  the  body,  such  as  chains,  coins,  a  watch,  etc.,  as 
these  are  good  conductors  of  the  electric  current,  it  will  be 
certain  to  include  them  in  the  circuit,  and  they  will  be  fre- 
quently found  to  have  been  melted. 

In  other  cases  of  death  by  lightning,  no  external  wound 
or  burn  may  be  visible.  Sometimes  there  may  be  severe 
external  injuries,  while  the  clothes  entirely  escape.  Again, 
the  clothing  may  be  completely  torn  off  the  body,  while  the 
latter  exhibits  no  injury  whatever. 

The  capricious  action  of  the  discharge  is  shown  by  the 
fact  that  out  of  a  party  of  three  or  four  sitting  under  a  tree, 
one  or  two  only  may  be  killed,  and  the  others  escape. 
Again,  it  has  occurred  that  persons  under  a  low  tree  have 
been  struck,  although  high  trees,  and  a  lightning  rod,  and 
an  iron  bridge  were  near  (Tidy).  Again,  the  same  dis- 
charge may  produce  in  one  person  wounds,  and  burns  in 
another.     The  diversity  of  its  action  on  the  clothes  may 


168  MEDICAL   JURISPRUDENCE. 

probably  be  explained  by  the  circumstance  of  a  portion  of 
the  clothing  being  wet,  and  a  portion  dry:  the  former, 
being  a  good  conductor,  might  escape  the  disruption  which 
would  be  exhibited  by  the  dry  portion,  which  is  a  bad 
conductor. 

Post-mortem  appearances. — In  case  of  instantaneous 
death,  the  body  maybe  found  in  the  exact  attitude  in  which 
it  was  struck.  Some  remarkable  instances  of  this  are 
recorded  in  the  books.  In  such  cases,  the  rigor-mortis 
occurs  immediately  after  death.  Hunter  supposed  that 
there  was  an  absence  of  the  usual  rigidity  after  death,  but 
in  this  he  was  in  error.  Coagulation  of  the  blood  also 
occurs,  although  it  is  delayed.  The  face  is  often  bloated 
and  discolored;  and  putrefaction  is  usually  very  rapid. 
Wounds  of  various  characters  are  observed — contused, 
lacerated  and  punctured ;  also  burns,  vesications  and 
ecchymoses;  these  latter  sometimes  exhibit  a  remarkable 
arborescent  appearance.  Occasionally,  fractures  of  the 
skull  and  of  other  bones  are  noticed.  The  blood  is  dark 
and  fluid. 

The  brain  and  its  membranes  generally  suffer  most 
severely,  the  head  being  usually  the  part  first  struck.  Con- 
gestion of  the  brain,  effusion  of  blood  under  the  skull  and 
into  the  ventricles,  and  even  complete  disorganization  of  the 
brain  substance,  have  all  been  observed.  The  lungs  are 
sometimes  found  congested  and  injured,  and  the  air  tubes 
full  of  mucus.  The  stomach,  intestines,  liver  and  spleen, 
are  also  usually  much  congested.  The  heart  does  not  ex- 
hibit any  special  alteration. 

The  medico-legal  interest,  in  cases  of  death  from  light- 
ning, is  centered  in  the  question  of  being  able  to  identify 
such  cases,  and  to  distinguish  them  from  those  of  homicidal 
violence.     A  close  observation  of  all  the  circumstances  of 


DEATH    BY    LIGHTNING.  1GD 

the  case — such  as  the  occurrence  of  a  thunder  storm  about 
the  time  of  the  death,  the  peculiar  appearance  of  the 
wounds  and  burns,  especially  if  the  two  co-exist  on  the 
same  body,  the  half-melted  appearance  of  metallic  articles, 
such  as  buttons  and  coins,  on  the  person  of  the  deceased, 
etc. — will  tend  to  throw  much  light  upon  it. 


170  MEDICAL   JURISPRUDENCE. 


CHAPTER  XI. 

DEATH  FROM  HEAT  AND  COLD. 

DIVERSE  EFFECTS  OF  HEAT  UPON*  THE  BODY. — POST-MORTEM  APPEAR- 
ANCES. — EFFECTS  OF  COLD. — POST-MORTEM   SIGNS. 

The  effects  of  extreme  heat  on  the  human  system  are 
familiarly  witnessed  in  tropical  and  semi-tropical  climates, 
during  the  heated  term,  in  the  mortality  arising  from  what 
is  popularly  denominated  sunstroke.  In  such  cases,  the 
dangerous  and  fatal  results  are  attributable  directly  to  solar 
heat.  But  effects  equally  serious  are  known  to  be  produced 
by  exposure  to  artificial  heat,  if  too  long  continued,  as  is 
witnessed  in  the  employes  in  engine-rooms,  factories,  etc., 
where  a  very  high  temperature  is  habitually  maintained. 
There  would  seem  to  be,  according  to  the  observations  of 
Dr.  H.  C.  Wood  [Phila.  Med.  Times,  1876),  three  distinct 
conditions  of  the  human  body  occasioned  by  excessive  heat, 
in  the  first  (which  is  rare),  we  have  acute  meningitis  or 
phrenitis  (coup-de-soleil) ;  in  the  second,  we  have  heat- 
exhaustion  with  collapse,  accompanied  by  a  rapid,  feeble 
pulse,  a  cool,  moist  skin,  and  a  tendency  to  syncope;  in  the 
third,  we  have  true  thermic  fever — that  condition  which 
results  especially  from  exposure  to  artificial  heat.  But 
something  more  than  mere  heat  is  required  to  produce 
thermic  fever.  It  does  not  occur  in  a  perfectly  pure  and 
dry  atmosphere,  because  the  profuse  perspiration  which  is 
immediately  developed  by  its  rapid  evaporation  keeps  the 
temperature  of  the  body  down  nearly  to  the  normal 
standard.     If,  however,  the  air  is  already  saturated  with 


EFFECTS  OF  HEAT  AND  COLD.  171 

moisture,  this  will  prevent  the  evaporation  from  the  body, 
and  its  temperature  will  rise  to  a  dangerous  height. 

The  symptoms  vary  in  intensity,  from  a  mere  headache 
with  drowsiness,  to  complete  insensibility,  coma,  and  para- 
lysis. In  many  instances,  death  appears  to  be  caused  by 
paralysis  of  the  heart. 

The  post-mortem  appearances  are  by  no  means  constant. 
In  some  cases  (true  conp-de-soleit)  we  find  decided  conges- 
tion of  the  brain  and  its  membranes,  with  serum  in  the 
ventricles,  together  with  congestion  of  the  lungs  and  of  the 
abdominal  viscera  generally;  and  the  heart,  as  in  ordinary 
death  from  asphyxia.  In  other  cases,  there  is  anaemia  of  the 
substance  of  the  brain,  along  with  distention  of  the  larger 
vessels  with  dark,  fluid  blood,  but  the  minute  vessels 
empty. 

Cases  of  insolation  do  not  often  claim  the  attention  of  the 
legal  physician,  yet  as  they  might  occur  remote  from  wit- 
nesses, and  with  a  fatal  termination,  it  is  proper  that  the 
medical  examiner  should  understand  their  nature,  together 
with  the  ordinary  accompaniments. 

The  effects  of  cold  upon  the  animal  body  are  immediately 
depressing,  but  if  it  be  of  short  duration,  and  the  system  is 
healthy,  reaction  takes  place  and  stimulation  follows.  The 
healthy  human  body  has  the  power  to  maintain  its  normal 
temperature  of  about  98. 6°  F.  independently  of  the  external 
temperature.  It  has  been  ascertained  by  actual  experiment 
that  a  warm-blooded  animal  will  not  survive  if  its  tempera- 
ture is  reduced  down  16  to  20  degrees  below  the  normal. 
There  is  no  authentic  account  of  the  recovery  of  a  warm- 
blooded animal,  much  less  a  human  being,  after  the  whole 
body  was  frozen,  although  fishes  and  other  of  the  lower 
animals  are  said  to  have  been  resuscitated  from  a  frozen 
state. 


172  MEDICAL  JURISPRUDENCE. 

Death  from  cold  is  hastened  by  whatever  exhausts  the 
system,  as  fatigue,  both  bodily  and  mental,  loss  of  rest,  want 
of  proper  food  and  nourishment,  mental  depression,  and  par- 
ticularly intoxication.  A  damp  cold  (such  as  wet  clothing) 
is  more  dangerous  than  a  dry  one.  The  fatal  effects  of  ex- 
posure to  cold  are  witnessed,  even  in  comparatively  tem- 
perate climates  during  the  winter,  in  the  cases  of  the  desti- 
tute, and  especially  where  this  condition  is  associated  with 
intemperance. 

Cases  of  death  from  cold  do  not  often  require  the  atten- 
tion of  the  medical  jurist.  There  are,  however,  certain  con- 
ditions under  which  they  may  occur,  which  demand  a  brief 
consideration. 

A  not  infrequent  form  of  infanticide  is  the  exposure  of  a 
new-born  child  to  the  extreme  cold  air.  Death  will  soon 
ensue  under  such  circumstances,  since  the  infant's  power  of 
resistance  to  cold  is  extremely  limited.  In  such  a  case  it 
will  be  the  physician's  duty  to  examine  the  body  of  the 
child,  and  consider  the  circumstances  of  the  case,  such  as 
the  place  where  it  was  found,  the  temperature  of  the  air,  the 
possibility  of  its  being  accidental,  etc.  As  regards  the  body, 
he  should  notice  if  the  pallor  is  extreme ;  if  frozen  stiff,  he 
should  distinguish  this  rigidity  from  rigor  mortis;  the  ar- 
terial color  of  the  blood;  the  accumulation  of  blood  on  both 
sides  of  the  heart  and  in  the  larger  vessels.  There  may 
also  be  marks  of  violence  upon  the  body. 

Occasional  instances  of  the  exposure  of  young  children 
to  cold  with  homicidal  intent,  are  recorded.  Such  a  case 
is  related  (Ann.  d'Hyg.,  9,  1831,  p.  207),  of  two  inhuman 
parents  causing  the  death  of  a  daughter,  aged  eleven  years, 
by  compelling  her  to  get  out  of  bed  on  a  very  cold  night, 
and  place  herself  in  a  vessel  of  ice-cold  water. 

In  the  treatment  of  the   insane,  the  barbarous   and  im- 


COLD POST-MORTEM    SIGNS.  173 

proper  use  of  the  cold  shower  bath,  for  reducing  intractable 
patients  to  submission,  was  formerly  much  more  in  vogue 
than  at  present.  It  need  hardly  be  said  that  such  treatment 
is  extremely  hazardous,  and  it  has  been  followed  by  fatal 
results.  Dr.  Taylor  records  an  instance  of  a  lunatic,  aged 
sixty-five,  who  was  subjected  to  the  cold  shower,  at  45 °  F., 
and  who  afterwards  took  a  dose  of  tartar  emetic ;  he  died 
in  fifteen  minutes  subsequently.  Cases  of  this  character 
would  very  properly  come  under  the  notice  of  the  legal 
physician,  and  the  authors  of  such  treatment  would  be 
justly  liable  to  indictment  for  manslaughter. 

Post-mortem  appearances. — These  cannot  be  considered  as 
very  characteristic ;  hence,  the  examiner  should  be  cautious 
in  deciding,  in  any  given  case,  as  to  whether  exposure  to  cold 
was  the  primary  cause  of  death.  All  the  circumstances  of 
the  case  here  require  special  consideration,  such  as  the 
season  of  the  year,  the  temperature  of  the  air,  the  place  of 
exposure,  etc.  Rigor  mortis  generally  sets  in  slowly,  and 
lasts  a  long  time.  According  to  Dr.  Ogston  {Brit,  and  For. 
Med.-Chir.  Review,  1855),  the  four  following  appearances,  in 
the  absence  of  any  other  obvious  cause,  would  justify  the 
conclusion  that  the  death  had  resulted  from  cold,  although 
the  signs  were  not  so  well  marked  in  children  as  in 
adults : — 

(1)  An  arterial  hue  of  the  blood,  except  when  viewed 
in  mass  within  the  heart ;  some  exceptions  are,  however, 
noted. 

(2)  An  unusual  accumulation  of  blood  on  both  sides  of 
the  heart. 

(3)  Pallor  of  the  general  surface  of  the  body,  and  con- 
gestion of  the  viscera  most  largely  supplied  with  blood.  In 
some  cases  the  congestion  of  the  brain  and  liver  was  only 
moderate. 


174  MEDICAL   JURISPRUDENCE. 

(4)  Irregular  and  diffused  dusky-red  patches  on  limited 
portions  of  the  exterior  of  the  body,  even  in  non-dependent 
parts  (distinguishing  them  from  suggillations). 

As  putrefaction  does  not  occur  at  a  freezing  temperature, 
the  discovery  of  a  decomposing  corpse  in  the  ice  or  snow 
would  afford  a  very  strong,  though  not  absolutely  conclus- 
ive, evidence  that  the  death  was  not  the  result  of  exposure 
to  cold,  but  rather  that  the  body  had  been  frozen  after  death. 


DEATH    BY    STARVATION.  175 


CHAPTER   XII. 

DEATH  BY  STARVATION. 

ACCIDENTAL,  HOMICIDAL  AND  SUICIDAL  STARVATION. — PRETENDED 
CASES  OF  VOLUNTARY  STARVATION. — SYMPTOMS  AND  POST-MORTEM 
SIGNS. — MEDICO-LEGAL   RELATIONS. 

Cases  of  death  by  Starvation  are  of  sufficiently  frequent 
occurrence  to  merit  the  notice  of  the  medical  jurist.  Acute 
starvation  implies  the  sudden  and  complete  deprivation  of 
all  food.  Chronic  starvation  is  the  result  of  a  continued  de- 
ficient supply  of  food,  both  in  quantity  and  quality.  Homi- 
cidal death  from  acute  starvation  is  very  rare,  but  cases  of 
accidental  death  from  this  cause  are  sufficiently  numerous, 
as  in  the  instances  of  miners  buried  in  the  earth,  shipwrecked 
mariners,  and  others  cut  off  from  food.  Occasionally,  pris- 
oners and  lunatics  will  undertake  to  commit  suicide  by  vol- 
untary abstinence  from  all  food;  in  the  great  majority  of 
cases,  however,  their  courage  fails  them  after  some  days'  ex- 
perience, and  they  give  up  the  attempt. 

The  many  notorious  cases  of  voluntary  fasting  which  have 
claimed  the  notice  of  the  public  during  the  past  years,  have 
proved,  on  close  investigation,  to  be  deceptions,  food  and 
drink  having  been  supplied  surreptitiously  to  the  individuals 
concerned.  Among  these  instances  may  be  mentioned  the 
case  of  Ann  Moore,  of  Tetbury,  England,  who  was  alleged 
to  have  abstained  from  all  food  from  1807  to  1813.  Another 
case  was  that  of  the  Welsh  Fasting  Girl,  aged  thirteen  years, 
who  is  stated  to  have  absolutely  fasted  for  two  years.  Both 
these  cases  were  shown  to  be  impostures.  The  notorious 
Dr.  Tanner,  of  our  own  country,  undertook,  for  a  considera- 


ITU  MEDICAL   JURISPRUDENCE. 

tion,  to  perform  the  feat  of  a.  forty  days'  absolute  fast,  in  New 
York,  in  August,  1880,  and,  to  all  appearance,  he  accom- 
plished it!  It  is  stated  that  during  all  this  time,  he  absolutely 
partook  of  nothing,  save  some  ounces  of  pure  water,  each 
day ;  and  that  his  loss  of  weight  at  the  end  of  forty  days 
was  thirty-six  pounds.  The  fluctuations  in  his  pulse,  tem- 
perature and  respiration  were  unimportant.  This  case  was 
not  under  very  strict  medical  supervision,  and  there  is  doubt 
about  its  perfect  genuineness;  this  would  seem  to  be  con- 
firmed by  the  fact  of  his  voracious  appetite  on  the  comple- 
tion of  the  fast,  unattended  by  any  bad  effects,  which  is  con- 
trary to  the  general  experience  of  others  who  have  been 
deprived  of  food  for  a  length  of  time. 

Chronic  starvation,  as  the  result  of  disease,  is  a  frequent 
cause  of  death,  as  is  witnessed  in  stricture  of  the  oesopha- 
gus, cancer  and  other  disorders  of  the  stomach  and  bowels, 
disease  of  the  pancreas,  marasmus,  etc.  It  is  likewise  the 
cause  of  disease  and  death  in  young  children  fed  upon 
unhealthy  milk  (either  from  the  nurse  or  cow),  where  this 
fluid  is  deficient  in  some  of  its  proper  constituents,  thereby 
causing  defective  nutrition.  Such  cases  are  abundantly 
illustrated  in  the  miserable  victims  of  baby-farming.  It  is 
also  witnessed  on  a  large  scale  in  districts  of  country  where 
famine  has  prevailed,  as  in  certain  parts  of  India,  and  in  the 
Irish  famine  of  1847. 

The  symptoms  of  chronic  starvation  are  generally  well- 
marked.  The  sense  of  hunger  is  not  very  urgent ;  emacia- 
tion, especially  in  the  last  stage,  is  extreme ;  the  eyes  are 
hollowed,  the  pupils  dilated;  the  skin  is  harsh  and  dry, and 
hangs  loosely  over  prominent  bones,  and,  in  chronic  cases, 
becomes  covered  with  a  brownish,  dirty-looking  coating, 
and  exhales  an  offensive  odor,  like  that  of  putrefaction. 
The  bowels  are   either  very  constipated,  or  the  faeces   are 


STARVATION.  177 

scanty,  dry  and  dark  colored.  There  is  great  muscular 
debility,  palpitation,  with  tinnitus  aurium;  pains  in  the 
stomach,  with  a  dry,  parched  mouth ;  the  intellect  some- 
times clouded,  but  again  clear  to  the  end,  with  despond- 
ency of  mind.  The  pulse  is  at  first  somewhat  quickened, 
afterward  it  is  slower;  the  temperature  is  usually  below 
that  of  health. 

Post-mortem  appearances. — Great  emaciation  of  the  body, 
with  an  almost  entire  loss  of  fat.  The  skin  shriveled,  and 
emitting  a  disagreeable  odor.  The  muscles  soft,  pale  and 
wasted.  The  brain  sometimes  congested,  and  at  others  pale 
and  soft,  with  effusion  of  serum  on  the  surface,  and  in  the 
ventricles;  the  lungs  healthy,  or  anaemic;  the  heart  more 
or  less  contracted,  and  void  of  blood ;  stomach  and  intes- 
tines contracted,  thin  and  transparent,  the  latter  usually 
empty ;  the  bladder  contracted  and  empty. 

As  regards  the  medico-legal  relations  of  starvation, 
although  it  is  rarely  the  cause  of  homicidal  death,  it  should 
be  remembered  that  the  law  does  not  require  the  absolute 
deprivation  of  food  to  be  proved,  but  only  the  necessary 
quantity  and  quality  to  be  withheld,  provided  this  has  been 
done  with  an  evil  intention. 


178  TOXICOLOGY. 


CHAPTER    XIII. 

DEATH    FROM     POISONING. 
(TOXICOLOGY.) 

Poisoning  is  the  most  frequent  of  all  the  causes  of  violent 
death  (the  casualties  of  war  excepted),  as  is  shown  by  the 
statistics  of  different  countries.  The  facility  with  which 
poisons  may  be  procured,  the  ease  with  which  they  can  be 
administered,  and  the  close  resemblance  that  many  of  them 
bear  to  disease  in  their  symptoms  and  post-mortem  lesions, 
will  account  for  the  fact  of  their  extensive  employment,  both 
for  homicidal  and  suicidal  purposes. 

The  science  of  Toxicology,  which  treats  of  the  nature, 
symptoms,  effects,  doses  and  modes  of  detection  of  poisons, 
is  very  properly  included  in  a  treatise  on  Medical  Jurispru- 
dence; and  since,  as  already  remarked,  so  large  a  proportion 
of  violent  deaths  is  to  be  ascribed  to  poisoning,  it  is  import- 
ant that  the  medico-legal  student  should  be  properly  in- 
structed in  this  branch  of  the  subject. 

SECTION    I. 

DEFINITION  OF  A  POISON.— EFFECTS. — PROOFS  OF  ABSORPTION. — 
SUBSEQUENT  DISPOSITION  OF  THE  POISON. — ELIMINATION. — HOW- 
DO  POISONS  CAUSE  DEATH? — CIRCUMSTANCES  MODIFYING  THEIR 
ACTION. — ANTAGONISM    OF   POISONS. 

A  Poison  is  a  substance  which,  when  introduced  into  the 
body  by  swallowing,  or  by  any  other  method,  occasions 
disease  or  death ;  and  this  as  an  ordinary  result,  in  a  state 
of  health,  and  not  by  a  mechanical  action.  It  must  be  as 
an  ordinary  result:  a  substance,  for  example,  which  affects 
one  person  injuriously,  through  idiosyncrasy,  is  not  a  poison. 


EFFECTS    OF    POISONS.  179 

Again,  it  must  be  in  the  healthy  system :  many  diseases  render 
the  system  extremely  susceptible  to  impressions  by  external 
agents ;  e.  g.,  in  gastritis,  the  blandest  substance — even 
water — may  excite  vomiting.  Again,  the  substance  must 
not  act  mechanically  :  thus,  powdered  glass,  fragments  of 
iron,  etc.,  may  produce  death  when  swallowed,  yet  these 
cannot  be  regarded  as  poisons. 

According  to  the  above  definition,  it  matters  not  by  what 
avenue  a  poison  gains  access  into  the  body,  its  ultimate 
effects  are  the  same.  The  stomach,  of  course,  is  the  most 
usual  means  ;  but  the  rectum,  the  skin,  the  lungs,  and  the 
cellular  tissue  by  hypodermic  injection,  and  even  the  nose, 
ear,  and  vagina  are  also  channels  of  entrance.  Inhalation 
of  poisonous  vapors  through  the  lungs,  and  the  subcuta- 
neous introduction  by  the  hypodermic  syringe,  affect  the 
system  far  more  rapidly  than  by  swallowing. 

The  mere  size  of  the  dose  constitutes  no  distinction, 
legally,  between  a  poisonous  and  a  non-poisonous  sub- 
stance; thus,  half  a  grain  of  strychnia,  or  half  an  ounce  of 
oxalic  acid,  may  be  the  quantity  which  proves  fatal. 

The  Effects  of  Poisons  are  local  and  remote.  The  local 
effects  are  the  direct  impressions  produced  on  the  part  of 
the  body  with  which  the  poison  comes  into  contact,  e.  g.y 
the  corrosion  of  the  stomach  and  bowels  by  the  immediate 
contact  of  the  mineral  acids  and  alkalies.  Often  a  poison 
may  act  both  locally,  by  its  causing  inflammation  of  the 
stomach,  and  also  remotely,  on  the  brain  and  nervous 
system.     Arsenic   frequently  acts  in  this  twofold  manner. 

The  remote  effects  of  a  poison  are  those  results  which  are 
produced  on  parts  of  the  system  remote  from  that  to  which 
it  was  first  applied.  These  remote  effects  constitute,  in  fact, 
the  usual  symptoms  of  poisoning — one  very  important  factor 
in  the  diagnosis  of  the  case. 


180  TOXICOLOGY. 

Mode  of  Action  of  Poisons. — In  order  that  a  poison 
should  produce  its  peculiar  effects  on  the  system,  it  is 
necessary  (except  in  the  case  of  corrosives)  that  it  should 
get  into  the  circulation,  so  as  to  be  conveyed  to  distant 
parts  of  the  body;  and  for  this  purpose  it  must  first  be 
absorbed.  Although  other  modes  of  transfer  of  the  poi- 
sonous impression  to  remote  parts  of  the  system  have 
been,  at  various  times,  recognized — such  as  nervous  com- 
munication, and  contiguity  of  structure — the  present  accepted 
doctrine  is  that  of  absorption  into  the  circulation. 

The  proofs  of  absorption  are  abundantly  afforded,  (i)  by 
the  detection  of  poisons  in  the  blood ;  (2)  in  the  secretions, 
especially  the  urine ;  and  (3)  in  the  different  viscera  of  the 
body,  as  the  liver,  kidneys,  lungs,  spleen,  brain,  etc.  An 
essential  part  of  the  duty  of  the  toxicologist  is  not  merely 
to  discover  the  poison  in  the  stomach  of  the  deceased  (since 
that  might  possibly  have  been  introduced  after  death),  but 
to  detect  it,  in  the  absorbed  state,  in  the  viscera. 

The  rapidity  of  absorption  is  materially  influenced  (1)  by 
the  solubility  of  the  poison  ;  (2)  by  the  nature  of  the  surface 
to  which  it  is  applied,  it  being  in  direct  ratio  to  the  vascu- 
larity of  the  part.  It  is  for  this  reason  that  the  most  rapid 
absorption  is  from  the  air-cells  of  the  lungs,  when  the  sub- 
stance is  inhaled  in  the  form  of  vapor.  For  this  same 
reason,  also,  when  it  is  injected  directly  into  the  blood 
vessels,  the  effect  is  almost  instantaneous.  Certain  animal 
poisons,  such  as  the  virus  of  glanders,  syphilis,  smallpox, 
etc.,  when  swallozued,  appear  to  undergo  a  change,  through 
digestion,  which  renders  them  innocuous.  The  absorption 
of  poisons  from  the  stomach  is  modified  by  the  full  or  empty 
condition  of  that  organ — being  most  rapid  when  it  is  empty. 
The  sound  skin  may  sometimes  become  the  avenue  for  the 
introduction   of   poisons,   as   witnessed    in    the    absorption 


DISPOSITION    OF   THE    POISON.  181 

of  arsenic,  tartar  emetic,  corrosive  sublimate  and  opium, 
when  applied  to  that  surface.  By  removing  the  cuticle,  the 
absorption  is  much  more  rapid,  as  seen  in  the  endermic 
method.  (3)  Fullness  of  the  blood  vessels.  The  rapidity  of 
absorption  is  inversely  to  the  quantity  of  the  circulating 
fluid ;  hence,  depletion  by  bleeding  or  purging  will  favor 
absorption. 

Subsequent  disposition  of  the  Poison. — After  absorption 
into  the  blood,  as  it  passes  through  the  different  organs,  a 
portion  of  the  poison  is  immediately  separated  by  these,  and 
is  at  once  eliminated  by  the  various  secretions,  as  the  bile, 
urine,  saliva,  pancreatic  fluid  and  sweat.  Another  portion 
is  temporarily  deposited  in  the  organs  and  tissues,  and 
usually  in  the  following  order,  as  to  quantity :  the  liver, 
spleen,  kidneys,  heart,  lungs,  brain,  pancreas,  muscles  and 
bones.  To  this  order  there  may  be  occasional  exceptions, 
as  some  recent  experiments  seem  to  prove  that  lead  and 
certain  other  mineral  poisons  show  an  especial  affinity  for 
the  spinal  marrow  and  brain.  Only  a  minute  quantity  of 
the  poison  is  circulating  in  the  capillaries  at  any  one  time ; 
yet  there  is  good  reason  to  believe  that  it  is  exclusively  this 
portion  which  is  really  noxious;  while  still  remaining  in  the 
stomach,  or  retained  in  the  organs,  it  is  harmless.  Hence, 
it  is  a  common  mistake  to  attribute  death  to  the  actual 
quantity  of  the  poison  found  in  the  stomach  of  the  deceased; 
this  is  only  the  surplus,  or  complement  of  what  was  neces- 
sary to  kill.  Although  that  portion  of  the  poison  which  is 
retained  in  the  organs  (absorbed)  is,  for  the  time  being, 
innocuous,  yet,  as  it  is  liable  to  be  reabsorbed  into  the 
circulation,  it  may  again  prove  active. 

While  we  have  no  positive  proof  that  all  poisons  are 
deposited  in  the  organs,  we  know  that  this  is  true  of  the 
mineral,  and  of  some  of  the  vegetable  poisons.    The  gaseous 


182  TOXICOLOGY. 

poisons  appear  to  be  eliminated  by  the  lungs  immediately, 
without  this  deposition.  This  was  proven  by  Bernard's  ex- 
periments with  sulphuretted  hydrogen  on  dogs  {Legons,^.  59). 
The  time  required  for  an  absorbed  poison  to  be  removed 
from  the  circulation,  either  by  elimination  or  by  deposition 
in  the  organs  or  tissues,  varies  for  different  substances,  and 
also,  probably,  for  different  conditions  of  the  system.  Cer- 
tain medicinal  substances  are  known  to  appear  in  the  urine 
a  few  minutes  after  being  swallowed,  e.  g.  iodide  of  potas- 
sium and  turpentine.  In  relation  to  mineral  poisons,  there 
is  reason  to  believe  that  they  are  rapidly  separated  from  the 
blood.  Experiments  have  shown  that  arsenic  may  be  dif- 
fused throughout  the  body  of  an  animal  in  an  hour  and  a 
half  after  being  swallowed.  It  has  also  been  found  in  the 
urine  of  a  horse  within  one  hour  after  administration.  Prof. 
Taylor  found  arsenic  in  the  human  liver  four  hours  after 
being  swallowed.  Doubtless,  it  reaches  this  organ  much 
sooner,  although  no  opportunity  has  as  yet  been  afforded  of 
proving  the  fact,  since  death  rarely  occurs  sooner  than  the 
above  period.  Taylor  believes  that  the  liver  acquires  its 
maximum  of  saturation  by  arsenic  in  fifteen  hours  after 
being  swallowed.  He  gives  a  table  of  the  estimated  aver- 
age amount  of  this  poison  that  will  be  found  in  this  organ 
at  different  periods  :  In  five  to  seven  hours  after  taking,  the 
quantity  is  0.8  grain;  in  nine  hours,  1.2  grains;  in  fifteen 
hours,  2.0  grains;  in  seventeen  to  twenty  hours,  1.3  grains; 
in  fourteen  days,  0.17  grains.  It  is  generally  admitted  that 
arsenic  is  entirely  eliminated  from  the  human  system  in 
about  fifteen  days ;  but  cases  have  been  reported  where  the 
poison  was  detected  in  the  urine  as  late  as  the  twenty-fifth 
day.  As  a  rule,  the  analyst  need  hardly  expect  to  find  any 
traces  of  arsenic  in  the  body  of  a  person  who  has  survived 
fifteen  days. 


CIRCUMSTANCES    MODIFYING    POISONS.  \  83 

Other  mineral  poisons  require  a  longer  time  for  their 
elimination  from  the  human  body.  According  to  M.  L. 
Orfila,  arsenic  and  corrosive  sublimate  require  thirty  days; 
antimony,  four  months;  silver,  five  months;  lead  and  cop- 
per, over  eight  months.     (Tardieu  sur  V Empoison.,  p.  19.) 

The  mode  of  death  by  poisons  has  been  a  subject  of  much 
discussion.  It  must  be  admitted  that  we  are  not  in  posses- 
sion of  the  full  explanation  of  this  subject.  We  know  that 
the  various  poisons  circulate  through  the  blood,  and  thus 
come  in  contact  with  the  different  organs,  and  then  produce 
their  specific  effects — one,  as  opium,  on  the  brain,  causing 
narcotism;  another,  as  prussic  acid,  on  the  heart,  producing 
asthenia;  a  third,  as  strychnia,  acting  on  the  spinal  cord, 
causing  tetanus,  etc.;  but  why  they  possess  this  elective 
affinity  for  different  organs,  we  are  unable  to  explain.  Neither 
do  we  understand  why  different  poisons  exhibit  a  similar 
election  in  their  modes  of  elimination  from  the  system,  e.g. 
iodide  of  potassium  passing  out,  by  preference,  through  the 
urine;  mercury,  by  the  saliva;  arsenic,  by  the  glands  of  the 
stomach,  etc. 

It  has  been  supposed  by  some  that  the  poison  produces 
some  chemical  alteration  in  the  blood,  thereby  rendering  it 
unfit  for  life.  This,  however,  cannot  be  proved,  although  it 
is  true  that  some  poisons,  when  introduced  into  the  circu- 
lation, do  undergo  a  chemical  change,  as  chloroform  into 
formic  acid,  and  the  salts  of  the  vegetable  acids  passing  out 
through  the  kidneys  as  carbonates ;  so,  also,  a  combination 
of  emulsin  and  amygdalin,  when  injected  into  the  blood,  re- 
sults in  the  production  of  prussic  acid.  This,  however,  fails 
to  explain  the  true  modus  operandi  of  poisons. 

Modifying  circumstances  connected  with  poisons. — Some 
of  these  relate  to  the  poison  itself,  and  others  are  connected 
with  the  system.    Among  the  former,  the  dose,  and  mode  of 


184  TOXICOLOGY. 

administration  require  notice.  As  a  rule,  the  larger  the  dose 
the  more  speedy  the  action.  An  exception  to  this  is  seen 
in  the  case  of  some  irritants,  such  as  arsenic,  where  a  large 
dose  may  be  rejected  by  vomiting,  and  might  thus  prove 
innocuous,  whilst  a  smaller  one  would  be  retained.  The 
effect  of  some  poisons  is  much  modified  by  the  dose;  thus, 
a  large  dose  of  oxalic  acid  kills  almost  immediately  by 
shock,  while  a  smaller  one  will  act  upon  the  heart  and  ner- 
vous centres,  and  prove  fatal  later. 

The  effect  of  combination  of  poisons  is  sometimes  to  in- 
crease, sometimes  to  diminish,  their  activity,  and  again, 
to  antagonize,  or  neutralize  their  action.  According  to 
Christison,  the  effects  of  arsenic  are  decidedly  modified  by 
intoxication,  which  seems  in  some  way  to  arrest  or  suspend 
its  action.  This  is  also  probably  true  of  other  irritant 
poisons.  The  same  authority  mentions  a  case  where  a  very 
large  dose  of  corrosive  sublimate  and  laudanum  was  taken, 
and  there  was  a  remarkable  postponement  of  all  the  usual 
symptoms. 

The  question  of  the  Antagonism  of  Poisons — that  is, 
whether,  by  a  combination  of  poisons,  their  action  upon 
the  human  system  will  become  so  modified  as  to  conceal 
the  symptoms,  and  prevent  their  discovery  after  death  by 
the  usual  chemical  tests — is  one  of  considerable  medico- 
legal importance.  This  doctrine  was  for  the  first  time,  we 
believe,  in  this  country,  urged  with  some  apparent  plausi- 
bility at  the  celebrated  trial  of  Dr.  Paul  Schceppe,  at  Carlisle, 
Pa.,  in  1869.  After  the  failure  by  the  prosecution  to  estab- 
lish the  allegation  of  poisoning  by  prussic  acid,  it  set  up  the 
claim  that  the  death  was  produced  by  a  mixture  of  this 
poison  and  morphia,  and  ascribed  the  absence  of  all  the 
usual  symptoms  of  prussic  acid  poisoning,  and  the  failure  to 


ANTAGONISM    OF    POISONS.  185 

detect  either  it  (except  by  the  merest  trace,  which  was  shown 
might  result  from  the  faulty  method  of  the  analysis)  or  the 
morphia,  to  the  alleged  antagonism  of  the  two  substances  ! 
In  the  year  1870,  the  author  made  a  number  of  experi- 
ments upon  dogs,  with  a  view  of  determining  this  question. 
A  few  of  the  results  will  be  briefly  detailed  here. 

(1)  Morphia  and  Prussia  Acid. — If  both  poisons  were 
given  in  full  lethal  doses,  the  symptoms  of  both  toxic  agents 
were  exhibited.  The  morphia  never  counteracts  the  fatal 
effects  of  the  prussic  acid,  if  the  latter  be  taken  in  full 
poisonous  doses. 

(2)  Morphia  and  Atropia. — The  mutual  antagonizing  in- 
fluence of  these  two  alkaloids  is  now  fully  recognized  in 
the  human  subject  ;  but  it  is  less  manifest  in  dogs. 

(3)  Strychnia  and  Prussic  Acid. — These  powerful  poisons 
evince  no  real  antagonism.  When  both  were  taken  in  full 
doses,  the  usual  symptoms  of  each  were  exhibited  alter- 
nately— ordinary  convulsions  and  tetanic  spasms. 

(4)  Strychnia  and  Morphia. — These  alkaloids  show  no 
disposition  to  antagonism,  when  given  in  full  doses.  The 
narcotism  of  the  morphia  (taken  first)  was  speedily  followed 
by  the  tetanus  of  the  strychnia  (taken  afterwards). 

(5)  Atropia  and Escrine. — The  investigations  of  Dr.  Frazer 
with  these  substances,  on  dogs  {Trans.  Roy.  Soc.  Edin.,  Vol. 
XXVI),  demonstrate  a  real  antagonism,  which  was  con- 
firmed by  the  author's  experiments. 

(6)  Atropia  and  Strychnia. — There  would  seem  to  be  a 
true  antagonism  between  these  two  alkaloids,  sufficient  to 
justify  a  resort  to  the  use  of  atropia  in  a  case  of  strychnia- 
poisoning. 

There  also  appears  good  reason  for  admitting  the  an- 
tagonism between  Aconite  and  Digitalis — sufficiently  so  to 
warrant   a   trial    of   digitalis    in    a    case    of   poisoning    by 


9* 


186  TOXICOLOGY. 

aconite.     (On  the  Antagonism  of  Poisons,  Am.  Jour.  Med. 
Sri.,  1 8; i.) 

The  conditions  of  the  system  that  modify  the  action  of 
poisons  are,  habit,  idiosyncrasy,  and  disease.  Habit  usually 
diminishes  the  power  of  poisons,  as  shown  especially  in  the 
case  of  the  narcotics  opium  and  alcohol.  It  is  also  alleged 
to  be  true  in  the  case  of  arsenic,  as  seen  in  the  arsenic-eaters 
of  Styria,  and  other  mountainous  countries. 

The  effect  of  disease  in  modifying  the  action  of  poisons 
is  witnessed  in  the  tolerance  by  the  system  of  opium  in  te- 
tanus and  mania-a-potu ;  and  of  its  increased  susceptibility 
to  this  drug  in  apoplexy  and  inflammation  of  the  brain.  In 
paralysis,  the  susceptibility  to  the  action  of  strychnia  is 
diminished. 

The  influence  of  sleep  is  usually  to  diminish,  or  retard  the 
action  of  poisons.  This  is  true  of  arsenic  and  the  irritants 
generally.  The  narcotism  produced  by  opium  seems  to 
produce  a  similar  effect,  and  also  to  mask  their  symptoms. 

SECTION  II. 

EVIDENCES  OF  POISONING. 

I.  EVIDENCES  FROM  SYMPTOMS. — 2.  FROM  POST-MORTEM  LESIONS. — 
3.  CHEMICAL  ANALYSIS. — POST-MORTEM  IMBIBITION  OF  POISONS. — 
RULES  IN  PERFORMING  A  TOXICOLOGICAL  ANALYSIS. — 4.  PHYSIO- 
LOGICAL EXPERIMENTS. — 5.  CIRCUMSTANTIAL  EVIDENCE. — MEDICO- 
LEGAL  CONCLUSIONS. — CLASSIFICATION. 

A  knowledge  of  the  evidences  of  poisoning  constitutes 
the  chief  business  of  the  toxicologist.  It  is  by  this  means 
that  he  reaches  a  definite  conclusion  in  the  cases  submitted 
to  his  investigation.  These  evidences  comprise:  (i)  those 
derived  from  the  Symptoms ;  (2)  those  obtained  from  the 
Post-mortem  appearances ;  (3)  those  afforded  by   Chemical 


SYMPTOMS    OF    POISONING.  187 

analysis ;  (4)  those  derived  from  Experiments  on  animals ; 
(5)  the  Moral  or  Circumstantial  evidences. 

I.  Evidences  afforded  by  Symptoms. — These  constitute  a 
very  important  factor  in  the  diagnosis  of  poisoning,  but 
alone,  they  can  never  be  sufficient  to  establish  the  charge, 
for  the  reason  that  there  are  no  characteristic  symptoms  of 
any  poison;  if  this  were  possible,  there  would  be  no  need  of 
ever  making  a  chemical  examination,  since  the  symptoms 
alone  would  be  sufficient  to  decide  the  case. 

The  first  of  these  symptoms  to  notice  is  their  sudden  oc- 
currence in  a  perfectly  healthy  person,  soon  after  taking  food 
of  drink.  Most  poisons  produce  their  effects  very  soon  after 
their  administration — some  of  them  almost  immediately. 
But  if  given  in  very  small  quantities,  and  at  intervals,  as  in 
slow  poisoning,  the  symptoms  may  come  on  gradually,  and 
be  readily  mistaken  for  disease.  The  physician  should  be 
extremely  cautious  about  mentioning  his  suspicions  of  poison 
in  a  case  of  this  character,  before  he  has  analyzed  the  sus- 
pected food  and  drink,  and  especially  the  urine  of  the  pa- 
tient. 

The  suspicion  is  strengthened,  if  several  persons,  after 
partaking  of  the  same  food,  are  suddenly  seized  with  the 
same  severe  symptoms.  But  even  here  it  might  happen 
that  some  disease,  like  cholera,  may  have  simultaneously 
attacked  several  persons,  after  partaking  of  a  meal.  Taylor 
mentions  an  instance  of  this  character,  occurring  in  London, 
where  three,  out  of  four  members  of  a  family,  under  suspi- 
cious circumstances,  were  suddenly  seized  with  violent 
symptoms,  which  proved  to  be  malignant  cholera,  which 
was  prevailing  at  that  time. 

A  third  feature  connected  with  the  symptoms  is  their 
rapid  course  tozuard  a  fatal  termination.     This,  however,  is 


188  TOXICOLOGY. 

not  of  much  practical  value,  since  the  most  active  poisons 
do  not  always  prove  fatal  immediately,  while,  on  the  other 
hand,  many  diseases  run  their  course  very  rapidly. 

From  what  has  just  been  said  about  symptoms,  it  will  be 
readily  understood  that  the  practical  difficulty  consists  in 
distinguishing  between  these,  and  the  symptoms  of  disease. 
We  shall,  therefore,  briefly  consider  those  diseases  whose 
symptoms  most  resemble  the  signs  of  poisoning. 

The  disorders  which  most  simulate  irritant  poisons  are 
cholera  morbus,  malignant  cholera,  gastro-enteritis,  perito- 
nitis, ulceration  of  the  stomach,  ilius,  and  hernia.  Those 
which  most  resemble  narcotic  poisoning  are  apoplexy, 
epilepsy,  inflammation  of  the  brain,  tetanus  and  cardiac 
diseases. 

Cholera  morbus  most  resembles  arsenic  poisoning,  and  it 
is  frequently  mistaken  for  the  latter.  Two  cases  of  this 
character  fell  under  the  author's  notice  a  short  time  ago, 
where  death  occurred  in  about  eight  hours,  both  of  which 
were  mistaken  for  cholera  morbus  by  the  attending  phy- 
sician, but  both  however  yielded,  by  analysis,  the  most 
positive  evidence  of  arsenic  poison. 

Malignant  cholera  most  resembles  the  action  of  tartar 
emetic  in  its  symptoms,  such  as  the  excessive  nausea  and 
vomiting,  the  rice-water  dejections,  the  cramps,  the  extreme 
weakness,  etc.  Gastro-enteritis,  peritonitis,  ulceration  of  the 
stomach,  ilius,  and  hernia,  all  present  symptoms  which 
strongly  resemble  many  of  those  witnessed  from  irritant 
poisons. 

Many  of  the  features  of  apoplexy  bear  a  striking  resem- 
blance to  the  symptoms  of  opium  poisoning;  whilst  epilepsy 
somewhat  resembles  poisoning  from  prussic  acid,  and  the 
effects  of  strychnia  bear  a  strong  likeness  to  those  of 
tetanus. 


POST-MORTEM    EXAMINATION.  189 

A  knowledge  of  the  above  facts  should  put  the  practi- 
tioner upon  his  guard  against  too  hastily  deciding  on  a  case 
of  poisoning  from  the  symptoms  alone ;  and,  on  the  other 
hand,  he  should  not  be  misled  in  attributing  to  a  supposed 
disease  what  is  really  the  result  of  a  poison. 

II.  Evidences  obtained  from  Post-mortem  Examination. — 
The  rules  governing  an  autopsy  in  a  case  of  poisoning  are 
the  same  as  those  which  regulate  other  judicial  post-mor- 
tem examinations.  One  important  rule  should  always  be 
observed,  namely,  that  the  examination  should  be  thorough 
and  exhaustive,  "  so  as  to  overlook  no  lesion  whatsoever, 
and  no  cause  of  either  accidental  or  natural  death."  The 
rules  already  given  for  conducting  a  post-mortem  investi- 
gation (Vid.  ante,  p.  56)  need  not  be  repeated  here.  It 
should  not  be  forgotten  that  a  careless,  superficial  autopsy 
of  a  body,  where  the  symptoms  had  strongly  resembled 
those  of  poisoning,  might  possibly  lead  to  the  conviction 
of  an  innocent  person. 

The  importance  of  receiving  the  stomach  and  other 
viscera  into  a  perfectly  clean  jar  may  be  inferred  from  the 
fact,  that  the  showing  that  this  vessel  was  not  clean,  at  the 
trial,  would  be  sufficient  to  destroy  all  the  chemical  testi- 
mony. This  is  well  illustrated  by  a  case  communicated  to 
the  author  by  the  late  Prof.  R.  Bridges,  which  occurred 
to  himself.  The  poison  suspected  was  arsenic,  but  the 
stomach,  etc.,  were  carelessly  thrown  into  an  old  tin  can 
that  had  formerly  contained  zinc-paint,  before  being  sent  to 
the  analyst.  He  discovered  zinc  in  the  viscera,  for  which 
he  was  at  a  loss  to  account,  until  the  above  fact  was 
ascertained. 

In  the  examination  of  the  stomach,  it  is  recommended  to 
open  this  organ  along  the  lesser  curvature,  and  after  care- 


190  TOXICOLOGY. 

fully  collecting  and  measuring  the  contents,  to  spread  it  out 
upon  a  clean  pane  of  glass,  with  the  mucous  surface  out- 
ward ;  it  should  then  be  carefully  inspected,  with  the  aid  of 
a  magnifier,  and  any  abnormal  appearance  noted,  together 
with  any  foreign  substance,  such  as  crystals  of  arsenic,  frag- 
ments of  phosphorus,  suspicious  powders,  pieces  of  vege- 
table matter,  etc.  These  should  afterward  be  examined  with 
the  microscope. 

The  evidences  furnished  by  the  post-mortem,  like  those 
derived  from  the  symptoms,  can  never  be  absolutely  con- 
clusive, but  only  strongly  suggestive — and  for  a  similar 
reason,  viz.,  because  many  diseases  exhibit  precisely  the 
same  post-mortem  lesions.  Sometimes  the  external  inspec- 
tion of  the  body  may  throw  some  light  on  the  case,  as  when 
certain  stains  of  the  mineral  acids  are  discovered  about  the 
mouth,  cheeks,  tongue  and  fauces,  and  also  on  the  dress  of 
the  person.  Occasionally,  the  odor  of  prussic  acid,  opium, 
alcohol,  nicotine  and  phosphorus  may  be  perceived  on  the 
corpse.  On  opening  the  body,  the  odor  of  the  above  sub- 
stances, if  present,  is  usually  more  decided  ;  and  in  phos- 
phorus-poisoning the  white  fumes,  which  are  luminous  in 
the  dark,  as  well  as  the  alliaceous  odor,  are  often  very  per- 
ceptible. Again,  the  remains  of  certain  poisons  may  be,  at 
times,  discovered  in  the  stomach  and  bowels,  such  as  can- 
tharides,  Scheele's  green,  nux  vomica,  arsenious  acid  and 
orpiment;  also  vegetable  leaves  and  fibres,  which  latter  may 
be  recognized  by  their  botanical  features.  The  aid  of  the 
microscope  may  also  be  required. 

As  regards  the  true  pathological  lesions  resulting  from 
poisoning,  it  may  be  remarked  that,  as  a  rule,  the  irritant 
poisons  leave  behind  them  decided  marks  of  congestion  and 
inflammation  of  the  mucous  membrane  of  the  stomach  and 
bowels,  together,  at  times,  with  ulceration,  perforation  and 


EVIDENCE    FROM    CHEMICAL    ANALYSIS.  191 

gangrene ;  while  the  neurotics  leave  their  impress  upon  the 
brain  and  spinal  cord,  in  the  form  of  congestion,  inflamma- 
tion and  effusion  in  these  organs,  and  sometimes  congestion 
of  the  lungs.  The  negative  evidence,  in  the  absence  of  all 
marks  of  irritation  of  the  stomach  and  bowels,  against 
irritant  poisoning,  although  strong,  is  not  positive,  because, 
in  exceptional  cases,  death  from  these  powerful  irritants 
may  occur  without  leaving  behind  any  pathological  lesion. 
Among  the  most  common  of  the  post-mortem  signs  pro- 
duced by  irritant  poisons  is  redness  ;  this,  however,  is  a  con- 
stant symptom  attendant  on  many  disorders,  and  according  to 
Dr.  Yellowly,  it  often  occurs  simply  as  a  post-mortem  change. 
Ulceration  is  occasionally  the  result  of  irritant  poisoning. 
The  author  has  seen  it  twice  in  acute  arsenical  poisoning. 
It  is  however  much  more  frequently  the  sequence  of  dis- 
ease; and  as  this  latter  is  apt  to  be  insidious,  and  generally 
unsuspected  until  a  sudden  fatal  termination,  it  might 
readily  be  mistaken  for  a  case  of  poisoning.  Softening  of 
the  mucous  lining  of  the  stomach  and  bowels  may  result 
from  both  poisoning  and  disease ;  it  cannot,  therefore,  be 
accepted  as  a  proof  of  the  former.  Perforation  may  occur 
from  the  action  of  a  corrosive,  as  the  mineral  acids  and 
alkalies,  and  also  from  disease ;  but,  in  the  latter  case,  the 
aperture  is  small,  while  in  the  former  it  is  large  and  ragged 
and  its  edges  are  soft  and  friable;  moreover,  the  poison 
escapes  into  the  abdomen,  and  can  there  readily  be  detected. 

III.  Evidences  from  Chemical  Analysis. — The  actual  dis- 
covery of  the  poison  by  means  of  chemical  analysis  is  usually 
regarded  as  the  most  satisfactory  and  positive  evidence  of 
poisoning;  and  it  is  a  prevalent  notion  that  the  case  cannot 
be  made  out  without  the  production  of  the  poison  as  the 
corpus  delicti.   This  is,  however,  an  error.    The  law  requires 


192  TOXICOLOGY. 

the  satisfactory  proof  of  death  by  poisoning.  The  question 
is — can  satisfactory  proof  be  afforded  without  the  chemical 
detection  of  the  poison  ?  The  reply  to  this  inquiry  is,  that 
it  undoubtedly  can,  in  certain  cases.  Many  convictions  have 
occurred  in  trials  for  poisoning,  without  this  particular  line 
of  proof.  If  it  were  always  deemed  absolutely  essential, 
doubtless  man}'  criminals  would  escape.  We  believe  this 
position  to  be  a  safe  and  logical  one  : — if  all  the  other  factors 
of  evidence  are  perfect — the  symptoms,  the  post-mortem 
appearances,  the  effects  on  living  animals,  and  the  moral 
evidences, — then  the  chemical  analysis  is  not  necessary  to 
substantiate  the  charge.  It  is  well  understood  that  for  some 
poisons  there  is  no  known  chemical  test,  especially  for 
those  derived  from  the  vegetable  and  animal  kingdom ; 
besides,  circumstances  may  interfere  to  prevent  a  proper 
chemical  examination.  If,  however,  the  other  branches  of 
evidence  fail,  and  if  at  the  same  time,  the  chemical  proofs 
are  unsatisfactory,  then  the  accused  must  be  acquitted. 

On  the  other  hand,  supposing  the  analysis  reveals  the 
presence  of  poison  in  the  stomach,  this  does  not  necessarily 
prove  that  the  death  resulted  from  poisoning.  Indeed,  in 
the  absence  of  the  usual  symptoms,  the  pathological  lesions, 
and  the  moral  proofs,  it  might  plausibly  justify  the  suspicion 
that  the  poison  had  been  secretly  introduced  into  the  body 
after  death,  for  sinister  purposes. 

The  detection  of  the  absorbed  poison,  in  the  organs,  as 
the  liver,  spleen,  kidney,  etc.,  is  justly  regarded  as  a  more 
satisfactory  proof  of  poisoning  than  the  mere  discovery  of 
it  in  the  stomach.  Indeed,  it  is  by  some  considered  as  posi- 
tive and  incontrovertible  evidence.  We  do  not  fully  assent 
to  this,  although  admitting  the  statement  as  correct  in  the 
majority  of  cases.  It  should  not  be  forgotten  that,  if  a 
poison  in  a  liquid  state  be  introduced   into  the  stomach  or 


POST-MORTEM    IMBIBITION    OF    POISONS.  193 

rectum  of  a  dead  body,  by  means  of  a  tube,  in  a  short  time 
the  liquid  will  penetrate  through  the  walls  of  the  viscus,  by 
osmosis,  and  will  come  in  contact  with  the  adjacent  organs 
— the  liver,  lungs,  pancreas,  kidney,  spleen,  etc. — and  will 
penetrate  into  these  organs,  so  as  to  contaminate  them  more 
or  less.  Now,  if,  after  several  weeks  or  months'  interment, 
a  suspicion  be  aroused  that  the  death  had  been  caused  by 
poison,  and  the  body  then  be  opened,  very  decided  evidences 
will  be  afforded  by  the  organs  of  what  might  very  naturally 
be  taken  for  absorbed  poison. 

Cases  of  post-mortem  imbibition  of  poisons  are  extremely 
rare;  indeed,  many  authors  deny  their  existence;  but  there 
is  good  reason  to  believe  that  they  have  occurred,  and 
that  they  may  be  repeated.  The  author  is  familiar  with 
the  facts  of  one  such  case,  the  particulars  of  which  were 
communicated  to  him;  and  in  order  to  establish  the  possi- 
bility of  its  occurrence,  together  with  the  circumstances 
most  favorable  for  its  production,  he  had  a  series  of  experi- 
ments made,  under  his  supervision,  by  Dr.  Geo.  McCracken, 
of  the  University  of  Pennsylvania,  on  the  bodies  of  dogs 
and  cats,  with  solutions  of  arsenious  acid,  corrosive  sub- 
limate and  tartar  emetic,  confining  his  experiments,  for  the 
time,  to  mineral  poisons.  These  solutions  were  severally 
injected  into  the  stomachs  of  the  animals,  and  their  bodies 
were  buried  for  periods,  respectively,  of  three,  five,  six  and 
seven  weeks,  when  they  were  disinterred,  opened,  and  the 
different  viscera  subjected  to  chemical  analysis,  with  the  fol- 
lowing results: — after  three  weeks'  burial,  in  the  case  of  all 
the  poisonous  solutions,  the  characteristic  colored  spots  of 
the  respective  sulphides  were  seen  on  the  spleen,  under  sur- 
face of  the  liver,  and  that  portion  of  the  peritoneum  posterior 
to  the  stomach, — yellow  in  the  case  of  arsenic ;  red  in  the 
case  of  antimony;  and  black  in  the  case  of  mercury.     Each 


1«U  TOXICOLOGY. 

of  the  metals  was  likewise  discovered  by  chemical  analysis 
in  the  liver,  spleen  and  left  kidney;  the  greatest  amount 
being  found  in  the  spleen ;  next,  in  the  portion  of  the  liver 
joining  the  stomach;  then  in  the  left  kidney;  and  next  in  the 
portion  of  liver  farthest  from  the  stomach ;  and  none  in  the 
right  kidney.  After  six  and  seven  weeks'  interment  the 
colored  sulphide  deposits  were  much  more  decided,  being 
noticed  on  the  upper,  as  well  as  the  lower  surface  of  the 
liver,  together  with  the  spleen,  intestines,  omentum  and  both 
kidneys ;  and,  in  the  case  of  arsenic,  even  extending  as  low 
down  as  the  fundus  of  the  bladder.  By  chemical  analysis, 
also,  the  poisons  were  detected  in  all  the  above-mentioned 
organs. 

The  inference  from  the  above  facts  would  naturally  lead 
to  the  necessity  of  excluding  the  idea  of  the  post-mortem 
introduction  of  the  poison,  in  every  toxicological  investiga- 
tion connected  with  a  trial  for  murder  by  poisoning.  It  is 
evident  that,  given  a  sufficient  motive  for  the  deed,  it  would 
not  be  a  very  difficult  matter  secretly  to  introduce  a  poison- 
ous liquid  into  the  stomach  of  a  dead  person,  and  after  the 
lapse  of  a  few  weeks  or  months  to  circulate  the  rumor  of 
the  death  having  been  produced  by  poison.  This  would  pro- 
bably lead  to  the  disinterment  of  the  body;  and  the  chemical 
examination  would  reveal  the  existence  of  the  poison,  not 
only  in  the  stomach,  but  also  in  the  liver  and  other  viscera. 
The  conclusion,  then,  would  naturally  be  that  the  individual 
had  died  from  poison,  because  it  had  been  discovered  in  the 
organs ;  and  this  alleged  discovery  might  lead  to  the  con- 
viction of  an  innocent  person.  Under  such  circumstances, 
we  deem  it  of  the  greatest  importance  to  examine  the  brain, 
because  a  poison  injected  into  the  stomach  could  not  pos- 
sibly find  its  way,  by  osmosis,  through  the  bony  cranium, 
into  the  brain.     The  finding  of  the  poison,  therefore,  after 


RULES    FOR    ANALYSIS.  195 

death,  in  the  brain  or  spinal  marrow,  maybe  regarded  as  one 
of  the  strongest  evidences  of  its  ante-mortem  administration. 
But  we  do  not  maintain  that  the  poison  must  be  found  in 
the  brain,  in  order  to  substantiate  the  charge. 

Chemical  analysis  sometimes  fails  to  discover  the  poison 
after  death,  and  for  this  failure  several  good  reasons  can  be 
assigned  :  (i)  It  may  all  have  disappeared  before  death,  by 
vomiting  and  purging,  and  by  elimination  through  the 
secretions.  Arsenious  acid,  however,  is  very  apt  to  adhere 
to  the  mucous  lining  of  the  stomach,  in  spite  of  long  and 
violent  vomiting.  (2)  It  maybe  undiscoverable  by  chemical 
analysis,  from  its  very  nature ;  there  is  no  known  reagent 
that  will  detect  the  poison  of  glanders  or  rabies,  and  also 
many  of  the  vegetable  poisons.  The  mineral  poisons  may 
usually  be  easily  identified.  (3)  Loss  by  absorption  and 
elimination.  This  is  apt  to  be  the  case  where  the  dose  of 
the  poison  was  only  just  sufficient  to  cause  death,  and  death 
was  not  very  rapid.  (4)  The  decomposition  of  the  poison 
in  the  blood,  or  during  its  elimination.  This  is  much  more 
apt  to  occur  with  organic,  than  with  inorganic  substances. 
(5)  Its  possible  decomposition  in  the  dead  body.  This  does 
not  occur  with  the  mineral  poisons;  although  the  chemical 
composition  of  these  may  undergo  change  after  death,  as, 
e.g.,  arsenious  acid  into  the  yellow  sulphide,  yet  the  metal 
remains  indestructible. 

In  performing  a  toxicological  analysis,  certain  rules 
should  be  observed,  which  will  greatly  facilitate  the  process. 
First  of  all,  the  examiner  should,  if  possible,  inform  himself 
of  the  character  of  the  symptoms,  and  (if  the  case  was  fatal) 
of  the  post-mortem,  as  these  will  usually  indicate  to  what 
particular  class  of  poisons  he  should  direct  his  researches. 
Secondly,  his  analysis  should  be  conducted  with  scrupulous 
care  and  accuracy.     In   searching  for   the   more   complex 


196  TOXICOLOGY. 

organic  poisons,  it  is  a  good  plan  to  reduce  the  liquid,  by 
evaporation,  to  a  very  small  bulk,  since  a  minute  quantity 
of  a  poison  diffused  through  a  large  amount  of  water 
may  fail  to  respond  to  the  proper  tests.  It  is  best,  also, 
to  operate  on  one-half  of  the  material,  reserving  the 
other  portion  in  case  of  accident,  or  for  further  experi- 
ments. The  suspected  substance  ought  to  respond  to 
all  the  recognized  tests,  the  characteristic  ones  being  first 
applied ;  and,  in  metallic  poisoning,  we  deem  it  essential 
for  the  analyst  to  produce  the  metal,  along  with  the  other 
results.  This  can  always  be  accomplished  without  much 
difficulty,  e.g.  in  the  case  of  arsenic,  mercury,  antimony, 
copper,  lead,  etc.  This  remark,  of  course,  does  not  apply 
to  the  metals  of  the  alkalies  or  earths.  Too  much  reliance 
should  not  be  placed  on  the  mere  color  of  precipitates,  as 
this  is  often  fallacious,  from  being  disguised  by  admixture 
with  foreign  matters,  or  uncertain,  from  its  resemblance  to 
other  substances.  As  instances,  we  may  cite  the  impure 
sulphides  of  arsenic  and  antimony,  the  two  liquid  tests  for 
arsenic,  and  the  resemblance  between  the  action  of  the 
persalt  of  iron  upon  opium,  and  upon  the  saliva.  Finally, 
the  analyst  should  be  careful  to  test  the  purity  of  all  his 
reagents,  remembering  that  many  of  the  so-called  chemi- 
cally pure  reagents  often  contain  impurities  which  may 
seriously  damage  his  examination. 

IV.  Evidences  from  Experiments  on  Living  Animals. — In 
cases  where  the  poison  cannot  be  identified  by  the  symp- 
toms, post-mortem  lesions  and  chemical  tests,  the  suspected 
material  may  be  introduced  into  a  living  animal  (a  dog,  cat, 
rabbit,  guinea  pig,  or  mouse),  and  its  effects  noted.  In  the 
case  of  strychnia,  the  frog  would  be  appropriate  as  a  cor- 
roborative test.     Birds  are  not  so  well  adapted  for  experi- 


CIRCUMSTANTIAL    EVIDENCE    OF    POISONING.  107 

ment.  The  character  of  the  information  thus  derived  is 
confined  to  the  mere  fact  of  poisoning,  together  with  some 
of  its  physiological  and  pathological  actions.  By  this  means 
the  presence  of  digitalis  was  identified  in  a  celebrated  French 
case,  and  aconite  in  the  case  of  Dr.  Lamson,  in  England. 

The  material  to  be  employed  in  such  cases  is  usually  the 
matters  vomited,  or  that  found  in  the  stomach  and  bowels 
of  the  deceased  ;  but  the  examiner  should  avoid  a  too  hasty 
conclusion,  inasmuch  as  disease  might  cause  the  secretions 
of  the  alimentary  canal  to  become  infected,  and  thus  to  act 
upon  the  animal  poisonously,  although  no  poison  had  really 
been  taken  by  the  deceased ;  and,  on  the  other  hand, 
although  poison  may  originally  have  been  present  in  the 
stomach,  it  might  have  all  been  expelled  by  vomiting,  or 
undergone  decomposition,  so  that  the  contents  of  the 
stomach  would  no  longer  produce  a  poisonous  impression 
on  the  animal. 

Another  fact  to  be  noticed  in  this  connection  is,  that  a 
poison  may  be  introduced  into  the  human  system  through  the 
body  of  an  animal \  without  the  latter  being  affected  by  it.  A 
case  is  recorded  where  a  family  exhibited  all  the  evidences  of 
belladonna-poisoning  after  partaking  of  a  rabbit  pie ;  the 
defence,  which  was  successfully  set  up,  was,  that  the  animal 
had  previously  eaten  of  the  belladonna  plant,  by  which  its 
flesh  had  become  poisonous.  It  is  well  known  that  the  cow 
and  goat  will  feed  upon  the  stramonium  with  impunity,  and 
that  their  milk  will  act  poisonously  upon  those  who  partake 
of  it. 

V.  Evidences  derived  from  Circumstances. — Although  the 
medical  expert  is  not  generally  concerned  with  this  sort  of 
testimony,  yet,  in  poison  cases,  the  medical  and  moral  evi- 
dence are  often  so  closely  connected  that  the  expert  may 


198  TOXICOLOGY. 

throw  considerable  light  upon  it.  These  "  circumstances  " 
are  the  following:  (i)  The  suspicious  conduct  of  the  accused 
before  tJie  event,  such  as  dabbling  in  certain  poisons  not  in 
the  line  of  his  calling.  This  was  a  very  strong  point  against 
the  Count  Bocarme  who  poisoned  his  brother-in-law  with 
nicotine.  (2)  The  purchase  and  possession  of  poison  by  the 
accused.  Of  course,  this  may  be  satisfactorily  accounted 
for.  (3)  The  proof  of  administration  in  the  food  or  drink  of 
the  deceased.  (4)  A  sufficiently  strong  motive  for  the  act. 
(5)  Suspicious  conduct  of  the  accused  during  the  illness,  and 
after  the  death  of  the  deceased — such  as  preventing  his  ob- 
taining medical  advice;  assuming  the  exclusive  care  of  the 
person,  as  to  the  giving  of  his  food  or  administering  the 
medicines ;  carefully  removing  and  disposing  of  all  vomited 
matters,  together  with  the  excreta;  and  expressing  the 
opinion  of  the  probability  of  a  speedy  and  fatal  termination 
of  the  case  ;  and,  after  the  death,  opposing  an  autopsy,  has- 
tening the  burial,  and  giving  a  false  account  of  the  illness. 

The  above  series  of  "  evidences  "  of  poisoning  constitutes 
a  chain  of  proof  which  is  perfectly  conclusive  in  any  indi- 
vidual case  ;  but  we  are  not  always  able  to  exhibit  every 
link  of  this  chain;  nor  is  this  always  necessary  in  order  to 
substantiate  the  allegation  of  poisoning,  since  "  satisfactory 
proof"  of  poison  having  been  the  cause  of  death  maybe 
made  out  in  the  absence  of  one,  or  even  two,  of  the  above 
"  evidences." 

Certain  medico-legal  questions  will  naturally  present  them- 
selves in  every  case  of  poisoning  that  comes  up  for  trial : 
(1)  Is  the  death  or  sickness  to  be  ascribed  to  poison?  This 
question  is  fundamental,  as  it  compels  the  expert  to  exhibit 
his  proofs  of  the  poisoning.  (2)  What  is  the  nature  of  the 
alleged  poison?     It  is  rarely  in  the  power  of  the  toxicologist 


MEDICO-LEGAL   QUESTIONS.  199 

to  exhibit  the  identical  poison  that  caused  the  death,  as  the 
corpus  delicti.  In  most  cases,  all  that  is  possible  to  do  is  to 
demonstrate  all  the  known  chemical  and  (occasionally) 
physiological  tests.  In  the  case  of  the  mineral  poisons,  it  is 
deemed  sufficient  to  exhibit  the  metal,  and  the  results  of  the 
recognized  chemical  reactions.  In  some  cases  of  mineral 
poisons,  however,  it  is  possible  to  extract  the  identical  sub- 
stance that  was  administered,  if  it  were  crystalline — such  as 
arsenious  acid,  corrosive  sublimate — and  tartar  emetic,  by 
the  process  of  dialysis.  (3)  Was  the  substa?ice  administered 
capable  of  causing  death?  This  question  is  likely  to  arise 
only  in  non-fatal  cases.  If  it  can  be  shown  that  the  sub- 
stance, although  criminally  administered,  was  not  poisonous 
(although  supposed  to  be),  conviction  would  not  follow; 
neither,  if  the  substance  were  poisonous  only  in  large  doses, 
as  oxalic  acid,  and  a  very  small  quantity — only  a  few  grains, 
had  been  given.  (4)  Was  the  poison  taken  in  sufficient  quan- 
tity to  produce  death?  The  discovery  of  a  large  amount  of 
poison  in  the  body  is  a  pretty  sure  evidence  of  the  cause  of 
death;  but  the  finding  of  only  a  minute  quantity,  or  its  total 
absence  from  the  body,  is  not  positive  proof  that  death  was 
not  caused  by  poison  (Vid.  ante,  p.  192).  (5)  When  was 
the  poison  taken?  This  question  can  generally  be  answered 
by  referring  to  the  time  of  the  first  appearance  of  the  symp- 
toms, together  with  their  duration;  but  it  is  affected  by 
various  conditions  (Vid.  ante,  p.  187).  (6)  May  the  poison 
have  entirely  disappeared  from  the  body,  without  leaving  any 
trace  ?  The  answer  must  be  affirmative,  if  the  person  has 
survived  long  enough  to  allow  of  its  complete  elimination 
(ante,  p.  181).  (7)  Might  the  poison  found  in  the  body  be 
ascribed  to  any  other  sou/re  than  to  poisoning  ?  Not,  if  it  is 
found  in  considerable  quantities,  and  in  the  absorbed  state, 
in  the  organs.     But,  if  in  minute  quantity,  it  might  have  been 


200  TOXICOLOGY. 

introduced  medicinally,  or  accidentally.  (8)  Can  poisoning 
be  pretended?  Undoubtedly,  just  as  various  diseases  are 
feigned  for  some  special  motive;  but  the  imposture  can  be 
discovered  by  close  watching.  The  idea  of  being  poisoned 
is  a  very  common  delusion  of  the  insane. 

The  above  medico-legal  questions  have  been  chiefly  taken 
from  the  treatise  of  Tardieu  [Sur  V Empoisonnemcnf). 

Classification  of  Poisons. — Of  the  numerous  classifi- 
cations of  poisons  which  have  been  proposed  at  various 
times,  two  only  require  notice  here.  One  of  these  is  founded 
on  the  natural  source  or  kingdom  from  which  the  poison  is 
derived,  and  is  expressed  by  the  two  classes  of  Inorganic 
and  Organic  poisons;  or  by  those  of  Mineral,  Vegetable  and 
Animal  poisons.  The  other  classification,  which  may  be 
termed  the  physiological,  has  reference  to  the  effects  of 
poisons  upon  the  healthy  animal  system.  The  classification 
adopted  in  the  present  treatise  is  founded  upon  the  latter 
arrangement,  as  being  the  most  philosophical.  It  is  based 
upon  the  one  proposed  by  Dr.  Taylor,  with  some  few  modi- 
fications. 

All  poisons  are  divided  into  two  Classes,  I.  Irritants ; 
II.  Neurotics. 

I.  Irritants. — These  include  such  poisons  as  produce  an 
irritant  action  upon  the  mucous  coat  of  the  alimentary  canal, 
the  effects  being  an  acrid,  burning  taste  on  swallowing, 
nausea,  vomiting,  purging,  pain  in  the  abdomen,  cramps  in 
the  stomach ;  the  matters  vomited  and  purged  being  at 
times  mixed  with  blood.  The  post-mortem  lesions  are  more 
or  less  inflammation  of  the  gastro-intestinal  mucous  mem- 
brane;  sometimes  ulceration,  perforation  and  gangrene. 

The  Irritants  may  be  subdivided  into  two  orders: 
(i)   Simple   irritants;    and   (2)   Irritants   possessing   remote 


CLASSIFICATION    OF    POISONS.  201 

specific  properties.  They  may  further  be  separated  into 
three  sections,  depending  on  the  source  from  which  they  are 
procured,  viz.  (a)  Mineral,  (b)  vegetable,  (c)  animal ;  and  the 
mineral  are  finally  subdivided  into  non-metallic  and  metallic. 
Some  of  the  irritants  are  properly  named  corrosives,  on 
account  of  their  destructive  chemical  action  on  the  tissues. 
If  diluted,  th?5  corrosives  act  as  simple  irritants. 

II.  Neurotics. — These  are  so  named  on  account  of  their 
specific  action  on  the  great  nervous  centres,  the  brain  and 
spinal  marrow.  The  symptoms  are  altogether  distinct  from 
those  of  the  former  class,  being  directed  especially  to  the 
brain  and  spinal  cord.  These  are  drowsiness,  giddiness, 
headache,  delirium,  stupor,  coma,  and  sometimes  convul- 
sions and  paralysis.  They  are  naturally  subdivided  into 
three  Orders:  (i)  Cerebral,  (2)  Spinal,  (3)  Cerebro-spinal. 
The  first  of  these  Orders  comprise  (a)  Narcotics,  (b)  Anaes- 
thetics. The  second  Order  includes  those  which  act  directly 
upon  the  spinal  cord,  such  as  strychnia  ;  they  are  sometimes 
termed  Tetanies.  The  third  Order  comprises  those  which  in- 
fluence both  the  brain  and  spinal  marrow,  producing  delirium, 
coma,  convulsions  and  paralysis.  These  latter  may  be 
grouped  under  the  three  heads  of  Deliriants,  Depressants  and 
Asthenics.  The  above  arrangement  is  to  a  great  extent  an 
arbitrary  one,  and  must,  of  course,  be  somewhat  imperfect,  as 
the  boundary  line  between  the  different  classes  and  orders  of 
poisons  cannot  always  be  accurately  drawn.  The  following 
tabular  arrangement  exhibits  the  classification  at  a  glance  : — 

TABLE    OF    CLASSIFICATION. 

ri         T     )  Order  1.  Irritants  proper.        (Mineral.    {Non-metallic. 

IrritIxts  f      "      2'         "        ProducinS     Veg'able.  }  Metallic. 
iRRiiAMb.  j  remote  specific  effects.     (  Animal. 

ri         TT      ]  Order  1.  Cerebral.     ( *arC0*C?: 
Class  II.  (  Anaesthetics. 

[      "      2.  Spinal  or  Tetanies. 

(  Deliriants. 

Neurotics,  j      "      3.  Cercbro-Spinal.     -j  Depressants. 

IO      I  I  Asthenics. 


202  TOXICOLOGY. 


CHAPTER  XIV. 

CLASS  I.— IRRITANT  POISONS. 
POISONING  BY  THE  MINERAL  ACIDS. 

CERTAIN  COMMON  SYMPTOMS. — POST-MORTEM  APPEARANCES. — TREAT- 
MENT.— CHEMICAL  ANALYSIS. — TOXICOLOGICAL  EXAMINATION  FOR 
THE   DIFFERENT   ACIDS. 

The  mineral  acids — Sulphuric,  Nitric  and  Muriatic — pos- 
sess certain  general  characters,  and  produce  certain  common 
effects  upon  the  system,  which  may  properly  be  considered 
together.  This  action  is  entirely  local.  They  are  seldom 
used  for  homicidal  purposes  except  in  the  case  of  young 
children ;  they  are  occasionally  employed  by  suicides,  but 
more  frequently  are  the  cause  of  accidental  death. 

Their  symptoms  are  exhibited  immediately  on  being  swal- 
lowed, and  consist  of  a  burning  in  the  mouth  and  gullet, 
with  intense  pain  in  the  stomach,  attended  with  constant 
eructations  and  vomiting  of  a  brownish  or  blackish  matter, 
often  mixed  with  blood,  together  with  mucus  and  shreds  of 
detached  mucous  membrane.  The  ejected  matters  are  in- 
tensely acid,  and  if  they  happen  to  fall  upon  a  marble  slab 
they  produce  effervescence;  they  also  change  the  color  and 
destroy  the  texture  of  the  cloth,  or  other  material,  on  which 
they  may  fall.  Swallowing  is  very  painful,  and  sometimes 
impossible.  Thirst  is  intense;  the  bowels  are  constipated 
and  the  urine  diminished.  The  pulse  is  small  and  weak 
and  the  skin  cold  and  clammy.  Respiration  becomes  diffi- 
cult, and  the  countenance  expressive  of  great  anxiety.  There 
may  also  be  cough  and  difficulty  of  speaking.     Death  may 


MINERAL  ACIDS TREATMENT.  203 

occur  from  suffocation,  when  the  force  of  the  acid  is  spent 
upon  the  glottis  and  upper  portion  of  the  windpipe.  The 
mouth  is  excoriated,  and  the  lips  are  stained  and  shriveled. 
When  the  acid  has  been  poured  far  back  down  the  throat, 
in  the  case  of  infants,  the  mouth  and  lips  may  entirely  es- 
cape injury,  the  corrosive  action  being  confined  to  the  glottis 
and  adjacent  parts.  The  mental  faculties  usually  remain 
clear,  the  patient  dying  convulsed  or  suffocated. 

The  result  is  generally  fatal,  although  the  period  of  death 
may  vary  from  a  few  hours,  to  weeks  or  months. 

Post-mortem  appearances. — Stains  of  a  brownish  or  yel- 
lowish hue  are  apt  to  be  found  on  the  lips  and  cheeks;  also, 
on  portions  of  the  dress  of  the  deceased.  The  lining  of  the 
mouth  and  tongue  is  shriveled  and  eroded,  stained  yellowish 
in  the  case  of  nitric  acid,  and  sometimes  of  a  whitish  color. 
At  times  the  mucous  membrane  of  the  windpipe  appears  to 
have  suffered  most  from  the  corrosive  action  of  the  poison, 
and  cases  are  reported  of  sulphuric  acid  poisoning,  where 
all  other  parts  of  the  body  had  entirely  escaped.  The  lining 
membrane  of  the  oesophagus  is  usually  softened,  detached 
in  long  shreds,  and  deeply  congested;  the  stomach  con- 
tracted, often  perforated,  sometimes  blackened,  containing 
a  dark  grumous  liquid;  at  other  times  it  presents  a  yellowish 
appearance.  The  intestines  are  likely  to  be  inflamed,  unless 
the  death  has  been  very  rapid.  If  the  contents  of  the 
stomach  have  escaped  into  the  cavity  of  the  abdomen, 
through  perforation,  the  peritoneum  will  be  found  intensely 
inflamed,  with  more  or  less  of  dark,  effused  blood. 

Treatment. — No  remedies  are  likely  to  prove  efficient 
when  the  undiluted  acid  has  been  swallowed.  The  proper 
treatment  consists  in  administering  a  solution  of  the  bi- 
carbonate of  potassium  or  sodium;  or,  in  the  absence  of 
these,  of  chalk  or  magnesia,  stirred  up  in  water,  together 


24 '  1  TOXICOLOGY. 

with  copious  diluents,  such  as  barley  water,  flaxseed  tea,  oil, 
etc.  The  stomach  pump  should  not  be  employed,  on  ac- 
count of  the  risk  of  perforating  the  softened  oesophagus. 

Sulphuric  Acid. — This  acid  is  commercially  named  Oil 
of  Vitriol.  In  its  concentrated  state,  it  is  a  heavy,  oily  liquid, 
of  a  light-brownish  color;  sp.  gr.  1.845;  intensely  sour,  and 
has  a  very  acid  reaction. 

The  diluted  acid  is  colorless,  very  acid,  non-corrosive;  it 
chars  paper  which  has  been  dipped  into  it  and  dried  by  the 
aid  of  heat. 

Sulphuric  acid  is  more  frequently  the  cause  of  death  than 
the  other  mineral  acids.  Several  cases  of  homicide  are  re- 
ported where  it  was  introduced  into  the  rectum  and  vagina. 
The  fatal  dose  for  an  adult  is  a  fluid  drachm;  for  an  infant, 
half  this  quantity.  The  danger  depends  more  on  the  degree 
of  concentration  than  upon  the  absolute  quantity  swallowed. 
Death  usually  occurs  within  twenty-four  hours,  and  in  cases 
where  its  action  is  spent  upon  the  rima  glottidis,  producing 
suffocation,  the  fatal  result  may  be  almost  immediate.  Ac- 
cording to  Casper,  the  bodies  of  those  poisoned  by  sulphuric 
acid  resist  putrefaction  for  a  long  period. 

There  is  good  reason  for  believing  that  this  acid  is  ab- 
sorbed into  the  circulation  and  eliminated  by  the  secretions. 
It  has  been  detected  in  the  urine  during  life. 

Chemical  analysis. — The  concentrated  acid  is  recognized 
by  its  oily  appearance;  it  chars  organic  bodies;  it  evolves 
considerable  heat  when  mixed  with  an  equal  bulk  of  water; 
it  gives  off  sulphurous  acid  fumes  when  boiled  with  copper, 
mercury,  wood  chips  or  charcoal.  The  diluted  acid  is  easily 
detected  by  its  producing  a  white  precipitate,  with  the  nitrate 
or  chloride  of  barium,  insoluble  in  nitric  acid.  To  confirm 
this  result,  the  precipitated  sulphate  of  barium  should  be 


TOXICOLOGICAL    EXAMINATION.  205 

dried  and  mixed  with  some  reducing  agent  (charcoal,  cyan- 
ide, or  ferrocyanide  of  potassium),  and  heated  to  redness  ; 
the  sulphate  of  barium  is  by  this  means  converted  into  the 
sulphide ;  and  when  this  is  moistened  with  diluted  hydro- 
chloric acid,  the  smell  of  sulphuretted  hydrogen  is  at  once 
perceived,  proving  the  presence  of  sulphur  in  the  original 
acid. 

It  ^y  be  objected  to  this  test  that  several  other  acids 
besides  sulphuric  throw  down  white  precipitates  with  nitrate 
of  barium,  as,  e.  g.y  carbonic,  phosphoric,  oxalic,  boric  acids, 
etc.  The  answer  to  this  is,  that  either  nitric  or  hydrochloric 
acids  will  immediately  dissolve  all  the  last-named  precipi- 
tates, while  the  sidpliate  remains  untouched  by  them. 

Another  objection  is  that  any  neutral  sulphate  will  pro- 
duce the  same  precipitate  with  nitrate  of  barium  as  the  free 
acid.  This  is  true ;  but  the  two  may  easily  be  distinguished 
by  evaporating  a  drop  of  the  suspected  solution  to  dryness 
on  a  piece  of  glass  ;  if  it  consisted  of  free  acid,  no  residue 
would  remain ;  but  if  it  contained  a  sulphate,  a  saline 
residue  would  be  left.  But  the  case  may  present  where  the 
solution  contains  both  the  free  acid  and  some  soluble  sul- 
phate; here,  finely-powdered  carbonate  of  barium  should  be 
added,  first  warming  the  liquid;  this  will  precipitate  the /nr 
sulphuric  acid  only  ;  hence,  the  resulting  sulphate  of  barium 
will  represent  all  the  free  acid  present. 

Another  delicate  test  is  veratria.  A  small  portion  of  this 
alkaloid  is  introduced  into  the  diluted  acid  and  carefully 
evaporated  to  dryness  ;  a  beautiful  crimson-purple  color  is 
developed.  Moreover,  as  this  test  produces  no  effect  upon 
a  sulphate,  it  serves  to  distinguish  the  latter  from  the  free 
acid. 

Toxicological  examination. — The  organic  matters,  if  thick 
and  viscid,  should  be  boiled  with   the  addition  of  distilled 


206  TOXICOLOGY. 

water,  and  the  solution  filtered,  and  a  measured  portion, 
acidified  by  nitric  acid,  next  precipitated  by  nitrate  of  barium, 
and  the  precipitate  washed  and  dried.  In  medico-legal  cases, 
this  precipitate  may  be  reduced  by  heat  and  ferro-cyanide 
of  potassium,  and  further  tested,  as  mentioned  above. 

It  might  happen  that  the  solution  contained  a  soluble  sul- 
phate, along  with  some  other  acid — citric,  acetic,  etc.  The 
mode  of  distinguishing  this  from  a  solution  containing  free 
sulphuric  acid  is  as  follows:  a  given  volume  of  the  solution 
is  acidulated  with  nitric  acid  and  precipitated  with  nitrate  of 
barium,  and  the  precipitate  washed,  dried  and  weighed.  An 
equal  volume  of  the  original  solution  is  evaporated  to  dry- 
ness, in  order  to  dissipate  any  free  sulphuric  acid,  and  is  then 
dissolved  in  pure  water,  filtered,  and  precipitated  as  before, 
and  the  dried  deposit  weighed.  If  the  weight  of  each  of  these 
precipitates  is  equal,  there  was  no  free  sulphuric  acid  present; 
but  if  the  weight  of  the  former  precipitate  exceeds  that  of  the 
latter  one,  then  the  excess  of  weight  will  indicate  exactly 
the  amount  of  the//r^  acid  present  in  the  original  solution. 

Detection  of  stains  on  clothing. — The  color  of  the  stains 
made  by  sulphuric  acid  on  dark  cloth  is  red  or  brownish-red, 
and  they  retain  their  moisture  for  a  long  time;  on  other 
colored  substances  they  produce  a  bright  red,  and  sometimes 
a  yellowish  stain.  To  recognize  the  acid,  a  few  of  these 
spots  should  be  cut  out  of  the  garment  and  boiled  with  a 
little  distilled  water,  and  tested  with  the  nitrate  of  barium. 
A  portion  of  the  cloth  should  also  be  tested  at  the  same 
time,  in  order  to  show  the  absence  of  any  sulphate. 

Quantitative  analysis. — Sulphuric  acid  is  estimated  as  a 
sulphate ;  the  precipitated  sulphate,  after  careful  washing  in 
hot  water,  with  a  little  hydrochloric  acid,  is  collected  on  a 
filter,  dried  and  weighed;  ioo  parts  of  the  sulphate  are 
equal  to  42.02  parts  of  monohydrated  sulphuric  acid. 


NITRIC   ACID — POST-MORTEM    LESIONS.  207 

Nitric  Acid  {Aqua  Fortis),  as  found  in  commerce,  is  a 
powerful  corrosive  acid,  of  a  yellow  or  orange  color,  the 
color  being  due  to  a  mixture  with  peroxide  of  nitrogen. 
Sp.  gr.  1.35  to  1.45.  It  is  apt  to  be  contaminated  also  with 
sulphuric  acid,  chlorine  and  iron.  It  is  seldom  used  as  a 
poison.  Orfila  relates  a  case  where  a  man  poured  this  acid 
into  the  ear  of  his  drunken  wife,  which  caused  her  death  by 
inflammation  of  the  brain  and  destruction  of  the  bones, 
seven  weeks  afterwards.  This,  however,  can  scarcely  be 
regarded  as  an  instance  of  poisoning. 

Symptoms. — Similar  to  those  caused  by  sulphuric  acid, 
except  that  the  lips,  tongue  and  inside  of  the  mouth  are 
stained  yellow.  Spots  upon  the  cheeks,  neck  and  other 
parts  of  the  body,  and  of  the  dress,  are  also  yellow.  The 
teeth  are  white,  but  yellowish  at  their  junction  with  the 
gums.  The  purging  is  sometimes  accompanied  with  blood. 
The  vapors  of  this  acid  may  cause  death  by  bronchial  con- 
gestion ;  care  should  therefore  be  taken  to  avoid  their 
inhalation  in  the  manufacturing  of  gun-cotton,  etc. 

Fatal  dose. — Two  drachms  of  the  concentrated  acid  have 
proved  fatal  to  an  adult;  though  larger  doses  have  been 
taken  with  impunity.  Life  is  usually  destroyed  within 
twenty-four  hours,  but  frequently  it  is  protracted,  and  in  a 
case  related  by  Tartra,  death  did  not  occur  for  seven  months. 

Treatment. — This  is  essentially  the  same  as  that  recom- 
mended for  sulphuric  acid. 

Post-mortem  appearances. — The  lips,  tongue  and  inside  of 
the  mouth  present  a  yellow,  or  yellowish-brown  appearance ; 
the  mucous  membrane  of  the  oesophagus  is  colored  yellow, 
softened,  and  peels  off  in  pieces;  the  larynx  and  glottis  may 
have  suffered,  as  in  the  case  of  sulphuric  acid.  The  stomach 
may  be  distended,  presenting  a  greenish  color,  due  to  the 
action  of  the  acid  on  the  bile;  it  may  be  found  in  a  pulpy 


TOXICOLOGY. 

state,  perforated,  and  adherent  to  the  adjacent  viscera,  and 
even  partially  destroyed.  The  contents  have  usually  a  yel- 
low color;  the  lining  membrane  is  deeply  congested,  and 
the  vessels  filled  with  dark  blood;  sometimes  the  open 
mouths  of  the  vessels  can  be  seen.  The  upper  portions  of 
the  intestines  may  exhibit  the  same  appearances  as  the 
stomach.  The  large  intestine  is  apt  to  escape.  In  chronic 
poisoning  there  is  great  emaciation,  and,  after  death,  con- 
traction of  the  pylorus,  with  softening  of  the  mucous  mem- 
brane, has  been  found. 

Chemical  analysis. — The  concentrated  acid  is  recognized 
by — (i)  giving  off  colorless,  or  orange-colored  fumes  when 
exposed  to  the  air;  (2)  by  leaving  no  residue  when  heated 
in  a  watch  glass;  (3)  by  giving  off  dense  orange-red  fumes, 
in  the  cold,  when  poured  on  fragments  of  copper,  or  on  mer- 
cury, zinc  and  tin  (dilute  acid  requires  to  be  boiled  on  these 
metals  to  produce  the  same  result);  (4)  by  its  negative 
action  on  gold  leaf;  but  if  about  twice  its  volume  of  strong 
hydrochloric  acid  be  added,  a  solution  of  the  gold  imme- 
diately takes  place. 

The  dilute  acid  is  tested  as  follows  :  (1)  The  addition  of 
nitrate  of  barium  and  nitrate  of  silver  causes  no  precipitates, 
showing  the  absence  of  sulphuric  and  hydrochloric  acids. 
(2)  Boil  with  fragments  of  copper ;  the  red  fumes  will  indi- 
cate the  nitric  acid  action.  (3)  Neutralize  with  carbonate 
of  potassium,  and  moisten  a  piece  of  filtering  paper  in  the 
resulting  solution  (nitrate  of  potassium) ;  when  the  paper  is 
dried,  it  will  scintillate  on  burning,  like  touch-paper. 
(4)  Evaporate  the  above  solution  until  crystallization;  ex- 
amine the  crystals  with  a  magnifier  (six-sided  striated  prisms 
of  nitre).  If  the  solution  be  neutralized  with  carbonate  of 
sodium,  the  crystals  will  present  the  rhombic  form  of  nitrate 
of  'sodiu'm.    (5)  Put  a  fragment  of  these  crystals  into  a  small 


TOXICOLOGICAL    EXAMINATION.  209 

test-tube,  along  with  a  little  copper  filings  and  a  few  drops 
of  sulphuric  acid  and  water  ;  slightly  heat,  when  there  will 
be  an  escape  of  orange-red  fumes,  and  the  production  of  a 
blue  liquid  (nitrate  of  copper).     (6)  Proceed  as  in  (5),  but 
instead  of  copper  filings,  add  a  fragment  of  morphia,  when 
an  orange-colored  solution  will  result,  the  color  becoming 
fainter  on  boiling.    (7)  As  in  (5),  substituting  for  the  copper 
a  crystal  of  brucia,  which  will  yield  a  blood-red   color,  dis- 
appearing on  the  addition  of  chloride  of  tin.     (8)   The  iron 
test.  Proceed  as  in  (5),  except  to  add  an  excess  of  sulphuric 
acid  and  allow  it  to  cool ;  then  pour  in  gently  a  freshly-pre- 
pared solution  of  sulphate  of  iron  ;  a  fine  purple  color  is 
immediately  formed  at  the  line  of  junction,  which  speedily 
extends  throughout  the  liquid,  if  cool;  if  heated,  the  color 
disappears   with    the    evolution   of  the    orange-red    fumes. 
(9)  A  weak  solution  of  sulphate  of  indigo  ;  when  heated  in 
contact  with  a  crystal  of  nitrate  of  potassium  and  sulphuric 
acid,  the  color  disappears.     (10)  As  in  (5),  using  a  crystal 
of  narcotina  instead  of  copper ;  a  reddish-brown  color  is  pro- 
duced, changing  by  gentle  heat  to  a  blood-red.     (11)   The 
gold  test,  as   in  (5),  substituting  for  the  copper  a  piece  of 
gold  leaf  and   some  pure  hydrochloric  acid  ;  the  gold  will 
dissolve,  and  the  solution  may  be  tested  by  protochloride  of 
tin,  which   imparts  to   it  a  purple   color.     (12)  As    in  (5), 
substituting   for  the  copper   a  fragment  of  pyrogattic  acid 
and  a  few  grains  of  chloride  of  sodium  ;  an  intense  purple 
hue  is  imparted  to  the  solution. 

Toxicological  examination. — First,  test  the  organic  mat- 
ters (as  contents  of  stomach,  etc.),  with  litmus  paper  ;  the 
acid  may  have  been  neutralized  by  the  alkaline  antidotes. 
If  viscid,  add  a  sufficient  quantity  of  distilled  water,  and  boil 
gently  for  about  a  quarter  of  an  hour;  filter  ;  if  found  to  be 
acid,  neutralize  with  carbonate  of  potassium  and  crystallize 
IO* 


'210  TOXICOLOGY. 

by  evaporation;  drench  the  crystals  with  strong  alcohol,  to 
remove  impurities,  and  test  them  by  the  methods  above 
described.  If  the  matters  examined  are  not  acid,  they 
should  be  boiled  with  strong  liquor  potassae,  to  break  them 
up  ;  then  add  sulphuric  acid ;  filter,  crystallize  and  test  as 
above. 

The  urine  should  always  be  examined  for  nitric  acid,  by 
distillation  with  sulphuric  acid,  and  neutralizing  the  distillate 
with  carbonate  of  potassium. 

The  tissues  may  be  examined  as  follows  :  Make  a  mixture 
of  equal  parts  of  sulphuric  acid  and  water,  and  put  twenty 
or  thirty  drops  into  four  test-tubes. 

To  (i)  add  a  little  brucia ;  no  change  should  result.  Add 
now  a  little  piece  of  the  tissue  to  be  examined,  when  the 
solution,  if  nitric  acid  be  present,  will  turn  a  blood-red 
color. 

To  (2)  add  a  trace  of  sulpliatc  of  indigo ;  no  action  should 
result.  Add  now  a  piece  of  the  tissue,  when,  if  nitric  acid 
is  present,  the  color  will  disappear. 

To  (3)  add  a  few  grains  of  copper  filings  and  a  piece  of 
the  tissue,  and  boil.  The  evolved  reddish  vapors,  if  nitric 
acid  be  present,  will  give  a  blue  color  to  a  piece  of  white 
paper  moistened  with  a  solution  of  iodide  of  potassium  and 
starch. 

To  (4)  add  a  solution  of  sulpliatc  of  iron  ;  on  adding  a 
piece  of  the  tissue,  the  solution  will  become  of  an  olive- 
brown  color,  if  nitric  acid  is  present.  (Woodman  and  Tidy, 
For.  Med.  p.  251.) 

Suspected  stains  are  examined  by  soaking  the  fabric  or 
^iher  substance  in  warm  distilled  water.  If  acid,  the  solu- 
tion should  be  neutralized  with  carbonate  of  potassium,  and 
the  resulting  crystals  treated  as  above  directed.  The  color 
of  these  stains,  as  before  mentioned,  is  yellow ;  they  can  be 


HYDROCHLORIC    ACID.  211 

distinguished  from  stains  of  iodine  and  bile  by  the  applica- 
tion of  a  weak  solution  of  potassa,  which  intensifies  the 
nitric  stain,  whilst  it  discharges  the  iodine  (or  bromine) 
stain,  and  does  not  affect  the  bile. 

Free  nitric  acid  in  solution  may  be  estimated  by  satu- 
rating it  with  recently  ignited  carbonate  of  sodium;  every 
53  grains  of  which  will  neutralize  54  grains  of  anhydrous 
acid  N2O5. 

Hydrochloric  Acid. — This  acid,  known  commercially 
as  Muriatic  Acid,  and  Spirit  of  Salt,  as  usually  found,  has 
a  light  yellow  color,  fumes  when  exposed  to  the  air,  is 
powerfully  acid,  and  has  a  sp.  gr.  of  about  1.15.  When  pure 
it  is  colorless;  its  yellow  hue  is  due  to  chlorine  or  chloride 
of  iron.  The  commercial  acid  frequently  contains  nitric 
acid,  arsenic  and  antimony,  as  impurities.  Instances  .  of 
poisoning  by  it  are  comparatively  rare,  except  as  the  result 
of  accident. 

Symptoms. — These  are,  generally,  similar  to  those  occa- 
sioned by  the  other  mineral  acids.  A  grayish  or  white  ap- 
pearance of  the  tongue  and  interior  of  the  mouth,  with  the 
formation  of  a  false  membrane,  is  usually  observed. 

Fatal  dose. — Half  an  ounce  for  an  adult;  a  drachm  has 
destroyed  a  child.  The  fatal  period  varies  from  a  few  hours 
to  many  weeks. 

The  treatment  is  the  same  as  that  above  described  for  the 
other  mineral  acids. 

Post-mortem  appearances. — These,  on  the  whole,  resemble 
the  lesions  found  in  cases  of  death  from  the  other  two  acids, 
although  they  more  closely  assimilate  the  appearances  pro- 
duced by  sulphuric  acid,  in  the  blackened  or  charred  ridges 
often  noticed  in  the  interior  of  the  stomach.  The  oesophagus 
presents  a  denuded  appearance,  from  the  detachment  of  its 


212  TOXICOLOGY. 

mucous  membrane.  The  glottis  and  larynx  may  also  be 
deeply  injected  and  corroded,  in  cases  where  the  poison  has 
spent  its  effects  on  these  organs. 

Chemical  analysis. — The  strong  acid  is  distinguished  from 
other  acids — (i)  by  its  yellow  color;  (2)  by  its  giving  off 
dense  white  fumes  in  contact  with  ammonia — best  shown  by 
holding  a  glass  rod  wetted  with  the  acids  over  an  open  bot- 
tle of  aqua  ammoniae;  (3)  by  its  negative  action  on  copper 
or  mercury,  even  when  heated;  (4)  by  its  evolving  chlorine 
when  heated  with  peroxide  of  manganese. 

The  dilute  acid  is  tested  by  a  solution  of  nitrate  of  silver, 
which  is  characteristic.  A  very  dilute  acid  gives  with  this 
solution  a  copious  white,  curdy  precipitate  of  chloride  of 
silver,  which  soon  darkens  on  exposure  to  light,  and  is  in- 
soluble in  boiling  nitric  acid,  but  very  soluble  in  ammonia. 
When  dried  and  heated,  it  fuses  into  a  yellow  liquid,  which 
on  cooling  becomes  a  soft,  horny  mass.  As  any  soluble 
chloride,  e.  g.  common  salt,  will  yield  the  same  precipitate 
with  nitrate  of  silver,  a  drop  of  the  original  solution  should 
be  evaporated  on  a  glass  slide;  if  it  was  free  acid  it  will  all 
disappear;  if  a  chloride,  a  residue  will  be  left. 

Nitrate  of  silver  also  precipitates  several  other  acids  and 
substances,  but  they  all,  with  the  exception  of  that  from 
hydrocyanic  acid,  dissolve  in  nitric  acid.  The  cyanide  of 
silver  is  also  soluble  in  bailing  nitric  acid;  and  is  further  dis- 
tinguished by  its  crystalline  appearance,  and  by  its  giving 
off  cyanogen  gas,  when  heated  in  a  glass  tube. 

Toxicological  examination. — As  this  acid  is  volatile,  the 
distilling  process  may  be  applied.  The  organic  matters 
(such  as  the  contents  of  the  stomach,  together  with  the 
viscera,  properly  cut  up)  should  be  put  into  a  glass  retort 
with  a  small  quantity  of  pure  water,  and  distilled  nearly  to 
dryness.     The  first  portion  of  the  distillate  maybe  rejected  ; 


HYDROCHLORIC    ACID    STAINS.  213 

but  the   remainder  will  usually  yield  the  characteristic  test 
with  nitrate  of  silver. 

The  above  method,  however,  is  liable  to  two  fallacies  : 
First,  there  is  always  apt  to  be  present  in  the  gastric  juice 
of  the  human  stomach  a  variable  quantity  of  normal  hydro- 
chloric acid;  and  secondly,  chloride  of  sodium  is  frequently 
found  there,  being  introduced  with  the  food.  Consequently, 
it  would  not  be  safe,  in  a  medico-legal  case,  to  rest  the  proof 
of  poisoning  by  hydrochloric  acid  on  the  chemical  analysis 
exclusively.  If  the  symptoms  and  the  post-mortem  lesions 
did  not  indicate  death  from  a  corrosive  acid,  the  mere 
detection  of  this  acid  after  death  by  the  chemical  examina- 
tion would  be  of  no  value. 

In  order  to  determine  whether  hydrochloric  acid  is 
present  in  the  free  state,  or  merely  as  a  chloride,  in  any 
organic  mixture,  or  whether  in  both  conditions,  the  solid 
matters  should  be  divided  into  small  fragments  and  sufficient 
distilled  water  added,  and  the  whole  gently  boiled  for  half 
an  hour,  then  cooled  and  filtered.  Equal  measures  of  the 
liquid  are  then  taken ;  one  is  precipitated  with  nitrate  of 
silver,  after  adding  a  little  nitric  acid,  and  the  precipitate  is 
washed,  dried  and  weighed.  Evaporate  the  second  portion 
of  the  original  liquid  to  dryness  in  a  water  bath,  so  as  to 
dispel  all  the  free  acid  ;  dissolve  the  residue  in  pure  water 
and  precipitate  with  nitrate  of  silver,  as  before ;  filter,  dry 
and  weigh  this  precipitate.  The  weight  of  the  first  pre- 
cipitate of  chloride  of  silver  will  give  all  the  hydrochloric 
acid  present — both  free  and  in  combination  ;  the  weight  of 
the  second  precipitate  indicates  only  the  combined  acid  ;  the 
difference  in  the  two  weights  will  indicate  the  amount  of 
free  acid  present  in  the  original  solution. 

The  stains  of  hydrochloric  acid  on  dark  cloth  are  at  first 
of  a  bright-red  color,  changing,  after  some  days,  to  a  red- 


214  TOXICOLOGY. 

dish  brown.  They  may  be  examined  after  the  method 
already  described.  The  experiment  should,  however,  be 
verified  by  testing  another  portion  of  the  garment  not 
having  a  stain. 

This  acid  is  sometimes  used  to  erase  ink  marks  in  cases 
of  forgery.  The  paper  thus  acted  on  should  be  treated  in 
the  same  manner  as  mentioned  for  the  cloth. 

Hydrochloric  acid  is  estimated  as  chloride  of  silver ; 
every  ioo  grains  of  the  latter  are  equivalent  to  77.80  parts 
of  acid  of  sp.  gr.  1.15. 


THE    ALKALIES.  215 


CHAPTER   XV. 

POISONING  BY  THE  ALKALIES  AND  THEIR  SALTS. 

SECTION  I.-POTASSA.-SODA.-AMMONIA. 

SIMILARITY  OF  EFFECTS. — SYMPTOMS. — FATAL  DOSE. — TREATMENT. — 
POST-MORTEM    APPEARANCES. — CHEMICAL  ANALYSIS. 

The  three  alkalies,  Potassa,  Soda  and  Ammonia,  on 
account  of  their  similar  qualities,  may  properly  be  considered 
together  in  their  toxicological  relations.  Their  effects  upon 
the  animal  system  are  very  analogous,  and  these  again 
strongly  resemble  the  impressions  produced  by  the  mineral 
acids — being  powerfully  caustic  in  their  concentrated  state. 
They  attack  the  tissues  with  which  they  come  in  contact  by 
virtue  of  their  chemical  affinities,  causing  their  disorganiza- 
tion and  complete  destruction.  They  are  very  rarely  used 
for  homicidal  poisoning,  but  they  occasionally  prove  fatal 
as  the  result  of  accident. 

Pure  canstic  potash  and  soda  are  found  almost  exclusively 
in  laboratories.  Commercial  potash  and  soda  occur  under 
the  names  of  pot  and  pearl  ashes,  and  soda  ashes,  or  soap 
lees.  These  are  all  impure  carbonates,  containing  a  variable 
proportion  of  the  respective  alkalies.  They  are  much  em- 
ployed in  the  arts  in  the  manufacture  of  glass  and  soap. 
They  are  highly  caustic  in  their  effects  on  the  system. 

Ammonia,  or  volatile  alkali,  in  its  pure  state,  is  a  gas  ;  the 
Aqua  Ammonia  of  the  shops  is  a  concentrated  solution  of 
this  gas  in  water,  and  is  a  highly  caustic  substance.  The 
two  former  alkalies,  together  with  their  salts,  are  fixed  when 
heated;  the  latter  is  volatilized  by  heat,  by  which  circum- 
stance they  are  readily  distinguished  from  each  other. 


216  TOXICOLOGY. 

Symptoms. — In  the  concentrated  state  they  occasion  an 
acrid,  nauseous  taste,  followed  by  a  burning  sensation  in  the 
throat  and  stomach;  violent  abdominal  pain,  increased  by 
pressure;  vomiting  of  mucous  matters,  tinged  with  blood; 
purging  of  a  similar  character,  with  tenesmus;  difficulty  of 
swallowing,  hoarseness  and  coughing.  The  pulse  is  quick 
and  feeble,  the  countenance  anxious;  the  body  is  covered 
with  a  cold,  clammy  sweat;  the  respiration  is  rapid,  with 
great  muscular  prostration.  Death  may  ensue  in  a  few 
hours,  or  it  may  be  postponed  for  months,  or  even  years. 
In  the  latter  cases,  the  fatal  result  is  owing  to  secondary 
causes,  such  as  stricture  of  the  oesophagus  and  of  the  py- 
lorus, occasioning  starvation. 

The  effects  of  swallowing  a  strong  solution  of  ammonia 
are  similar  to  those  above  described,  except  that  they  are 
often  more  rapid,  and  are  apt  to  be  directed  to  the  organs  of 
respiration  by  the  vapor  given  off. 

The  incautious  application  of  the  vapor  of  ammonia  to 
the  nose,  in  cases  of  syncope,  is  sometimes  followed  by  fatal 
results,  for  this  same  reason. 

Fatal  dose. — As  in  the  case  of  the  mineral  acids,  the  fatal 
effects  of  the  alkalies  depend  rather  upon  their  degree  of 
concentration  than  upon  the  actual  amount  swallowed. 
Half  an  ounce  of  caustic  potash  is  the  usual  fatal  dose;  but 
an  ounce  and  a  half  of  the  solution  of  the  shops,  containing 
about  forty  grains,  has  caused  death.  Strong  aqua  ammonite 
has  proved  fatal  in  the  dose  of  two  drachms ;  but  instances 
of  recovery  are  more  frequent  from  this  than  from  the  fixed 
alkalies.  Recovery  has  occurred  after  swallowing  over  an 
ounce  of  liquid  ammonia. 

Treatment. — The  stomach  pump  should  never  be  used. 
Dilute  vinegar  or  lemon  juice  should  be  freely  swallowed, 
together  with  oil,  or  other  demulcents.     Opium  may  be  given 


TESTS    FOR    POTASSA.  217 

to  quiet  pain,  and  stimulants  to  counteract  the  depression. 
The  inhalation  of  acetic  acid  might  prove  beneficial  in  poi- 
soning by  vapor  of  ammonia. 

Post-mortem  appearances. — The  lining  membrane  of  the 
mouth,  throat,  oesophagus  and  stomach  exhibit  evidences  of 
corrosion  in  their  softened  and  abraded  condition;  at  times 
the  mucous  coat  of  the  stomach  is  blackened  from  the  effused 
blood,  and  may  be  completely  destroyed.  The  larynx  and 
bronchi  maybe  inflamed  and  softened,  especially  in  the  case 
of  ammonia  poisoning.  In  chronic  cases,  the  mucous  mem- 
brane of  the  oesophagus  may  be  much  thickened,  and  its 
calibre,  as  also  that  of  the  pylorus  of  the  stomach,  extremely 
contracted. 

Chemical  properties. — All  the  alkalies  neutralize  acids,  turn 
turmeric  paper  brown,  and  restore  the  blue  to  reddened  litmus. 
They  are  not  precipitated  by  sulphuretted  hydrogen,  am- 
monium sulphide,  or  ammonium  carbonate.  Corrosive  sub- 
limate causes  a  yellowish  precipitate  with  the  fixed  alkalies, 
and  a  white  one  with  ammonia. 

Potassa  is  distinguished  from  soda  as  follows: — 

(i)  BicJdoi'ide  of  platinum  causes  with  the  former,  if  not 
too  dilute,  a  yellow  double  chloride  of  potassium  and  pla- 
tinum, which  under  the  microscope  is  seen  to  be  in  octahedral 
crystals.  But  this  reagent  will  also  precipitate  ammonia ; 
hence,  in  an  analysis,  the  absence  of  the  latter  alkali  must 
be  insured.  Ammonia  can  readily  be  detected  by  heating  a 
little  of  the  suspected  liquid  in  a  test-tube  with  hydrate  of 
lime ;  the  vapor  may  be  recognized  by  its  odor,  and  by  its 
action  on  turmeric  paper. 

(2)  Tartaric  acid  throws  down  from  a  strong  solution  of 
potassa,  or  its  salts,  a  white  crystalline  precipitate  (cream 
of  tartar).     This  action  may  be  facilitated  by  adding  a  little 


218  TOXICOLOGY. 

alcohol,  and  by  stirring  with  a  glass  rod.     Here,  also,  the 
absence  of  ammonia  must  first  be  proved. 

(3)  Neutralize  each  alkali  with  nitric  acid,  and  evaporate 
the  solutions.  The  resulting  crystals  are  readily  distin- 
guishable. The  potassic  nitrate  {nitre)  is  in  six-sided,  striated 
crystals  ;  the  sodic  nitrate  is  in  cubes. 

(4)  Heated  on  a  platinum  wire,  in  the  blowpipe  flame, 
potassa  gives  a  violet  color ;  soda,  a  yellow  one. 

(5)  Antimoniate  of  potassa  (freshly  prepared)  yields  with 
soda  and  its  salts,  a  white  crystalline  antimoniate  of  soda. 
This  reagent  gives  no  precipitate  with  potassa  or  ammonia; 
but  is  affected  by  several  of  the  metallic  salts. 

(6)  The  spectrum  process  is  an  exceedingly  delicate  test 
for  either  soda  or  potassa,  giving  with  the  former  a  well- 
defined  yellow  band,  and  with  the  latter  tzvo  lines,  one  in  the 
yellow,  and  one  in  the  blue  space. 

(7)  Polarized  light  affords  a  most  delicate  test  for  soda. 
A  drop  or  two  of  the  solution,  to  which  a  drop  of  hydro- 
chloric acid  has  been  added,  is  put  upon  a  glass  slide,  and 
a  drop  of  the  solution  of  bichloride  of  platinum  is  then 
added,  avoiding  an  excess.  The  mixture  is  next  to  be  care- 
fully evaporated,  until  it  begins  to  crystallize ;  it  is  then 
placed  under  the  microscope,  furnished  with  a  polarizer. 
On  turning  the  analyzer  until  the  field  becomes  perfectly 
dark,  the  crystals  exhibit  a  beautiful  play  of  colors  ;  whilst, 
if  no  soda  is  present,  no  effect  is  produced.  According  to 
Prof.  Andrews,  sjtooo  of  a  grain  may  be  thus  detected  (CJiem. 
Gas.  X,  p.  378). 

Toxicological  examination. — The  mixture  will  usually  have 
a  soapy  feel  and  frothy  appearance.  The  absence  of  am- 
monia should  first  be  established  (ante.  p.  217).  Evapo- 
rate to  dryness,  and  heat  to  redness  in  a  capsule,  in  order 


TESTS    FOR    SALTS    OF    AMMONIA.  210 

to  char  the  organic  matters.  The  ash  is  then  to  be  digested 
in  distilled  water  and  filtered;  the  alkali  will  be  found  in 
the  solution  as  a  carbonate,  when  it  may  be  tested  as  above 
described. 

If  required  to  separate  the  caustic  alkali  from  the  carbo- 
nate that  may  be  present  in  the  original  mixture,  the  latter 
must  first  be  evaporated  to  dryness,  and  the  residue  treated 
with  absolute  alcohol,  which  will  dissolve  out  the  free  alkali, 
but  not  the  carbonate.  After  filtration,  evaporate  to  dry- 
ness and  incinerate ;  dissolve  the  residue  in  water,  and  test 
as  above  directed. 

Quantitative  determination. — Potash  is  estimated  as  a 
double  chloride  with  platinum  {ante,  p.  217).  The  precipi- 
tate should  be  washed  with  strong  alcohol,  dried  and 
weighed.  Every  IOO  parts  of  the  double  chloride  represent 
22.5  parts  of  caustic  potassa,  or  28.25  parts  of  anhydrous 
carbonate. 

Chemical  analysis  of  Ammonia  and  its  salts. — Solution  of 
ammonia  {aqua,  or  liquor  ammonia)  is  a  colorless  liquid, 
having  a  very  pungent  odor,  and  an  acrid,  alkaline  taste. 
When  heated  it  evolves  gaseous  ammonia.  It  leaves  no 
residue  when  evaporated  to  dryness.  It  gives  to  a  solution 
of  a  copper  salt  a  characteristic  purple  color. 

The  salts  of  ammonia  are  colorless,  and  volatilize  when 
heated;  and  if,  at  the  same  time,  they  are  mixed  with  lime 
or  potassa,  they  yield  the  characteristic  ammoniacal  odor. 
The  other  tests  for  the  salts  of  ammonia  are — (1)  bichloride 
of  platinum;  (2)  tartaric  acid;  (3)  carbazotic  (or  picric)  acid; 
(4)  Nesslers  test — this  consists  of  adding  an  excess  of  iodide 
of  potassium  to  corrosive  sublimate  until  the  mercuric  iodide 
formed  is  redissolved,  an  excess  of  free  potassa  being  added; 
it  gives  a  brown  discoloration  with  the  smallest  trace  of 
ammoniae. 


220  TOXICOLOGY. 

Toxicological  examination. — If  the  mixture  be  in  a  state 
of  decomposition,  it  will  be  useless  to  attempt  the  analysis, 
inasmuch  as  ammonia  is  a  result  of  the  putrefactive  process. 
Unless  it  be  found  in  very  small  quantities,  the  characteristic 
odor  will  determine  its  presence.  Distill  over  about  a  fourth 
of  the  organic  liquid,  conducting  the  vapors  into  a  well- 
cooled  receiver,  containing  a  little  water,  and  test  the  solu- 
tion as  above  directed.  If  no  ammonia  be  given  off,  then 
examine  the  contents  of  the  retort  for  an  ammoniacal  salt, 
by  first  treating  with  strong  alcohol ;  filter  the  solution,  and 
re-distill,  along  with  hydrate  of  lime  or  potassa;  this  will 
yield  the  free  ammonia. 

Ammonia  is  determined,  quantitatively,  like  potassa : 
every  iOO  parts  of  the  double  chloride  represent  7.62  parts 
of  pure  ammonia. 

SECTION  II. 
TOISONING  BY  THE  ALKALINE  AND  EARTHY'  SALTS. 

NITRATE  OF  POTASSIUM. — BITARTRATE  OF  POTASSIUM. — SULPHATE  OF 
POTASSIUM. — ALUM. — CHLORINATED  POTASS.E  AND  SODA.— SALTS 
OF   BARIUM. 

Nitrate  of  Potassium  [Nitre  ;  Saltpetre). — This  salt  is  much 
used  in  the  arts,  especially  for  the  manufacture  of  gun- 
powder; it  is  likewise  employed  in  medicine,  in  small  doses. 
It  occurs  in  six-sided,  striated  crystals;  taste  saline  and 
cooling;  very  soluble  in  water;  deflagrates  when  thrown 
upon  hot  coals ;  gives  off  nitrous  fumes  when  acted  upon 
by  sulphuric  acid. 

Symptoms. — In  large  doses,  and  in  the  concentrated  state, 
it  acts  as  a  powerful  irritant  to  the  alimentary  mucous 
membrane,  causing  violent  burning  pain  in  the  gullet  and 
stomach;  vomiting,  sometimes  of  blood;  bloody  stools; 
cold,   clammy   skin ;    weak,   frequent    pulse ;    collapse    and 


POISONING    BY    NITRE.  221 

death.  Besides  these  evidences  of  a  local  irritant  action,  it 
occasions  certain  nervous  symptoms,  such  as  convulsions, 
tremors,  partial  paralysis,  loss  of  speech  and  delirium. 
Occasionally,  a  very  large  dose  has  produced  comparatively 
slight  local  symptoms,  while  the  impression  upon  the 
nervous  centres  has  been  more  decided. 

Fatal  dose. — Death  from  this  salt  is  generally  the  result 
of  accident,  it  having  been  swallowed  by  mistake  for  other 
salts.  An  ounce  to  an  ounce  and  a  half  taken  in  a  concen- 
trated state,  has  frequently  proved  fatal  in  a  few  hours.  The 
largest  dose  recorded  to  have  been  taken  is  mentioned  by 
Wharton  &  Stille  {Med.  Jurisp.  1884,  ii,  p.  no).  A  Ger- 
man, by  mistake,  swallowed  three  and  a  half  ounces  of  this 
salt.  He  complained  of  but  slight  pain  or  sense  of  heat  in 
the  stomach,  and  was  purged  three  times  within  three  or 
four  hours.  About  five  hours  after  taking  the  nitre,  he 
suddenly  fell  out  of  his  chair  and  expired.  There  was  no 
autopsy.  In  this  case,  the  excessive  dose  of  the  poison 
seemed  to  have  destroyed  life  by  shock.  The  rigor  mortis 
was  very  imperfect,  and  the  countenance  and  lips  retained 
their  life-like  appearance  to  a  remarkable  degree  for  three 
days  after  death. 

Post-mortem  appearances. — The  lining  membrane  of  the 
stomach  is  usually  highly  inflamed,  and  detached  in  places ; 
perforation  has  been  observed  in  one  instance.  The  intes- 
tines are  often  similarly  affected.  The  contents  of  the 
stomach  are  sometimes  tinged  with  blood. 

Treatment. — Free  vomiting  should  be  promoted  by  the 
use  of  bland  mucilaginous  drinks ;  opium  and  stimulants, 
to  relieve  pain  and  depression;  together  with  external  appli- 
cations, as  fomentations,  etc.  There  is  no  chemical  anti- 
dote. 


'222  TOXICOLOGY. 

Toxicological  examination. — See  Nitric  Acid,  p.  208. — Ac- 
cording to  Orfila  and  Wohler,  nitre  has  been  detected 
in  the  urine,  liver,  spleen  and  kidneys  of  those  poisoned 
with  it. 

Bitartrate  of  Potassium  {Cream  of  Tartar). — This  salt  is 
very  much  used  in  medicine,  and  is  not  generally  considered 
to  be  poisonous ;  but  in  large  and  concentrated  doses — two 
ounces — it  has  proved  fatal,  causing  symptoms  strongly 
resembling  those  produced  by  nitre. 

Alum  [Sulphate  of  Aluminum  and  Potassium). — This  salt, 
in  large  doses,  is  very  irritant  to  the  stomach  and  bowels, 
producing  vomiting  and  purging,  although  in  small  quanti- 
ties its  action  is  that  of  an  astringent.  It  has  proved  fatal 
to  animals,  but  no  death  in  the  human  subject  has  been 
recorded. 

Sulphate  of  Potassium,  like  the  foregoing  salts,  is  highly 
irritating  in  large  doses.  It  has  occasioned  death  in  the 
quantity  often  drachms  and  upwards.  It  is  used  sometimes 
as  an  abortive,  and  with  fatal  results.  Arsenic  has  at  times 
been  found  as  an  impurity  in  this  salt,  derived,  doubtless, 
from  an  impure  sulphuric  acid  used  in  its  manufacture. 
Arsenic,  in  this  way,  might  find  its  way  into  Dover's  penvder, 
etc.  It  would  be  proper  to  test  for  arsenic  in  any  sample  of 
this  salt  which  causes  irritation. 

Large  doses  of  the  ordinary  purgative  salts,  under  certain 
circumstances,  may  prove  powerfully  irritating,  and  even 
fatal.  Instances  of  death  following  the  administration  of 
overdoses  of  Epsom  salt  and  common  salt  are  reported  by 
Christison  and  Taylor. 


POISONING    KY   SALTS    OF    BARIUM.  223 

Chlorinated  Soda  and  Potash. — Known  in  commerce  as 
Bleaching  Salts,  and  much  used  in  France  for  cleansing 
clothes,  have  occasionally  produced  fatal  effects  when  swal- 
lowed. Tardieu  has  reported  such  a  case  (Sur  i  Empoisonne- 
ment),  where  a  child  died  some  weeks  after  taking  this  sub- 
stance in  divided  doses.  It  was  identified  by  the  discovery  of 
an  abnormal  quantity  of  chloride  of  sodium  in  the  urine  and 
kidneys;  also,  by  the  formation  of  chloride  of  lead  on  the 
leaden  mouth-piece  of  the  bottle  which  contained  the  poison, 
and  likewise  by  characteristic  stains  of  a  reddish-white 
color  on  the  child's  cap. 

Salts  of  Barium. — All  the  compounds  of  barium  (with 
the  exception  of  the  insoluble  sulphate)  are  poisonous. 
They  occasion  symptoms  very  analogous  to  those  caused 
by  nitrate  of  potassium,  such  as  pain  in  the  stomach, 
vomiting  and  purging,  with  decided  nervous  symptoms,  and 
palpitation  of  the  heart.  The  post-mortem  lesions  are  inflam- 
mation of  the  mucous  coat  of  the  stomach  and  bowels,  great 
congestion  of  the  brain  and  lungs,  and  the  heart  full  of  dark 
blood. 

The  proper  treatment  is  to  promote  the  evacuation  of  the 
poison  by  the  use  of  emetics  and  mucilaginous  drinks,  and 
the  free  administration  of  sulphate  of  sodium,  or  magnesium, 
and  the  subsequent  use  of  antiphlogistic  remedies. 


221  TOXICOLOGY. 


CHAPTER   XVI. 

ORDER    II.— IRRITANTS    POSSESSING    REMOTE    SPECIFIC 
PROPERTIES. 

This  subdivision  of  the  Irritants  includes  such  poisons 
embraced  under  Class  I  as,  besides  producing  inflammation 
of  the  gastro-intestinal  mucous  membrane,  cause  other 
symptoms,  which  indicate  an  impression  on  the  great 
nervous  centres.  Several  of  the  alkaline  and  earthy  salts 
already  described  are  of  this  character,  and  might  very 
properly  have  been  considered  under  this  head,  but  they 
were  more  conveniently  discussed  in  connection  with  the 
Alkalies. 

SECTION  I. 

POISONING  BY  PHOSPHORUS. 

SYMPTOMS. — FATAL    DOSE. — TREATMENT.— MORBID    APPEARANCES. — 
DIAGNOSIS. — CHEMICAL   ANALYSIS. — AMORPHOUS   PHOSPHORUS. 

Phosphorus,  in  combination,  is  largely  diffused  as  a  con- 
stituent of  the  animal  body.  Its  presence  is  essential  to  the 
performance  of  its  normal  functions,  and  this  is  especially 
true  in  reference  to  the  great  nerve  centres,  of  which  it  con- 
stitutes a  comparatively  large  proportional  part.  It  is 
eliminated  from  the  system  in  the  urine,  in  the  form  of 
phosphates. 

In  its  free  state,  phosphorus  is  a  powerful  irritant  poison. 
It  is  less  employed  for  poisoning  in  this  country  than  in 
Europe,  and  is  seldom  used  for  homicidal  purposes.  Fatal 
results  have  frequently  occurred  by  its  accidental  and 
suicidal  employment — chiefly  the  former — from  the  swallow- 


PHOSPHORUS FATAL  DOSE.  225 

ing  of  phosphorus-paste  (used  for  destroying  vermin),  and 
the  tops  of  lucifer  matches. 

Symptoms. — These  do  not  usually  appear  for  some  hours 
after  the  poison  has  been  taken.  There  is  first  perceived  a 
disagreeable,  garlicky  taste,  and  an  alliaceous  odor  may 
often  be  noticed  from  the  breath.  This  is  followed  by  a 
burning  pain  in  the  throat  and  stomach,  with  intense  thirst 
and  nausea,  distention  of  the  abdomen,  with  vomiting  and 
purging  ;  pupils  dilated  ;  cold  perspiration,  and  great  anxiety, 
with  small,  frequent  and  irregular  pulse.  The  matters  first 
vomited  generally  exhale  an  alliaceous  odor,  and  are 
luminous  in  the  dark;  their  color  is  dark  green,  or  like 
coffee  grounds.  The  discharges  from  the  bowels  have  also 
been  observed  to  be  phosphorescent.  Sometimes  convul- 
sions precede  death  ;  again,  the  patient  may  die  quietly,  or 
in  a  coma.  If  the  case  is  protracted  for  some  days,  jaundice 
is  apt  to  occur,  and  likewise  hemorrhage  from  the  stomach, 
bowels,  nose  and  other  parts  of  the  body.  Paralysis  is  an 
occasional  result.     The  urine  is  highly  albuminous. 

Chronic  poisoning,  accompanied  with  all  the  above  symp- 
toms, though  in  a  less  violent  degree,  may  result  from  the 
inhalation  of  the  vapors  of  phosphorus  in  the  manufacture 
of  lucifer  matches.  This  form  of  poisoning  comes  on  very 
insidiously,  and  is  very  apt  to  be  fatal.  It  generally  mani- 
fests itself  first  in  the  jaws,  causing  caries  of  the  teeth  and 
necrosis  of  the  bone.  Some  authorities  state  that  this  form 
of  necrosis  cannot  attack  those  who  have  perfectly  sound 
teeth,  but  only  those  whose  teeth  are  carious  (St.  Barth. 
Hosp.  Reports,  vol.  XII).  And  it  is  further  stated  that  in 
some  match  factories  it  is  required  that  the  workmen  should 
have  sound  teeth. 

Fatal  dose. — Less  than  a  grain  has  proved  fatal.  A  child 
died  after  sucking  two  matches;  another  older  child  died  from 
1 1 


226  TOXICOLOGY. 

the  effects  of  swallowing  the  tops  of  eight  matches.  Dr. 
Taylor  mentions  the  case  of  a  lunatic  who  died  from  swal- 
lowing one-eighth  of  a  grain  (On  Poisons,  p.  315). 

Phosphorus  is  occasionally  employed  in  medicine,  in  doses 
of  -fa  to  sV  of  a  grain;  but  even  in  these  small  doses  its 
effects  are  uncertain,  and  it  may  sometimes  act  with  unex- 
pected severity. 

Fatal  period. — It  is  not  to  be  classed  among  the  rapidly 
fatal  poisons.  It  usually  causes  death  in  from  one  to  four 
or  five  days;  in  exceptional  cases,  earlier.  Casper  quotes 
the  case  of  a  young  lady  who  died  in  twelve  hours  after  swal- 
lowing three  grains  of  phosphorus  in  the  form  of  an  electuary 
(Fore//.  Med.,  II,  p.  100).  Dr.  Habershon  reports  a  case  which 
proved  fatal  in  half  an  hour.  Cases  of  chronic  poisoning 
ma)'  last  for  months,  or  even  for  years. 

Treatment. — There  is  no  chemical  antidote  known..  Free 
emesis  should  be  encouraged  by  the  use  of  albuminous  and 
mucilaginous  drinks  holding  hydrate  of  magnesia  in  sus- 
pension. The  use  of  oil  is  objectionable,  as  this  is  a  solvent 
for  phosphorus,  and  would  consequently  tend  to  diffuse  the 
poison.  Oil  of  turpentine  is  highly  recommended  by  Dr. 
Percy  (Prize  Essay,  1872)  as  a  reliable  antidote,  if  given 
early,  and  before  the  poison  is  absorbed.  The  old  oil,  or 
that  which  has  become  oxygenated,  is  to  be  employed,  not 
the  fresh  hydrocarbon.  He  also  recommends  the  introduc- 
tion of  oxygenated  water  into  the  stomach,  through  a  tube, 
and  the  inhalation  of  free  oxygen  into  the  lungs. 

Animal  charcoal  has  also  been  recommended,  from  its 
power  of  absorbing  free  phosphorus,  and  likewise  nitrate  of 
silver,  from  its  power  to  form  an  insoluble  compound  of 
silver  and  phosphorus  (Brit,  and  For.  Med.-Chir.  Rev.,  1870). 

It  has  been  supposed  by  some  that  the  poisonous  effects 
of  phosphorus  are  owing  to  its  conversion  into  phosphorous 


PHOSPHORUS POST-MORTEM    LESIONS.  227 

acid,  at  the  expense  of  the  oxygen  of  the  blood  ;  but  there 
is  orood  evidence  to  show  that  it  is  absorbed  and  eliminated 
imcombined,  as  the  urine  has  been  observed  to  be  luminous. 
It  is  more  probable  that  it  acts  as  a  blood,  poison.  The 
blood  corpuscles  undergo  a  speedy  disintegration,  which  is 
doubtless  the  cause  of  the  ecchymoses  seen  upon  the  differ- 
ent organs. 

Post-mortem  appearances. — According  to  Tardicu  {Sur 
ly  Empoissonemcnt,  p.  437),  who  has  given  special  attention 
to  this  subject,  the  lesions  produced  by  phosphorus  vary 
according  to  the  form  in  which  it  is  taken.  It  is  when  in 
the  pure  state,  or  simply  dissolved  in  oil,  that  it  most  fre- 
quently occasions  lesions  in  the  oesophagus  and  alimentary 
canal.  Fragments  of  phosphorus  may  be  discovered  ad- 
hering to  the  mucous  membrane,  even  of  the  large 
intestines,  and  at  these  spots  the  bowel  is  liable  to  perfora- 
tion during  the  examination.  In  the  oesophagus,  stomach 
and  intestines,  ecchymotic  or  gangrenous  spots  are  scat- 
tered about.  The  mesenteric  glands  are  engorged,  and 
often  soft  and  friable. 

In  other  cases,  as  in  poisoning  by  phosphorus-paste,  there 
may  be  no  special  morbid  appearance,  but  even  in  the 
absence  of  redness  or  ulceration,  there  will  be  ecchymoses, 
more  or  less  abundant,  over  the  mesentery  and  visceral  peri- 
toneum. The  pleural  and  pericardial  sacs  contain  bloody 
serum.  Irregular  bloody  spots  are  scattered  over  the  pleura, 
pericardium,  and  even  the  endocardium.  The  heart  is  soft, 
distended,  or  contains  fluid  blood.  The  blood  itself  is  very 
dark,  fluid,  and  syrupy ;  it  appears  to  be  completely  devital- 
ized ;  the  corpuscles  are  disintegrated  and  transparent,  by 
loss  of  their  coloring  matter.  In  certain  cases,  the  mucous 
coat  of  the  stomach  and  duodenum  is  so  softened  as  to 
break  under  pressure  of  the  knife  ;  ulcerations,  also,  some- 


22S  TOXICOLOGY. 

times  occur  in  the  stomach.  It  is  stated  that  the  in- 
testines, and  even  the  flesh,  of  animals  poisoned  by 
phosphorus  have  the  odor  of  garlic,  and  appear  luminous 
in  the  dark. 

This  luminosity  of  the  viscera  has  been  observed  in  the 
human  subject. 

The  exterior  of  the  body  often  exhibits  an  icterode  ap- 
pearance. Sometimes,  the  red  or  blue  coloring  matter  of 
the  lucifer  matches  that  have  caused  death  may  be  found 
adhering  to  the  inside  of  the  alimentary  canal,  a  considerable 
time  after  death.  The  general  appearance  of  the  gastro- 
intestinal mucous  membrane  is  hemorrhagic  rather  than 
inflammatory,  ecchymoses  being  scattered  throughout.  The 
contents  of  the  intestines  are  liquid  and  bloody.  The 
bladder  contains  bloody  urine,  and  often  presents  sub- 
mucous ecchymoses. 

A  peculiar  pathological  alteration,  revealed  by  the  micro- 
scope as  the  result  of  phosphorus- poisoning,  is  fatty  degen- 
eration of  the  liver,  and  other  organs  of  the  body.  But  these 
peculiarities  are  not  absolutely  characteristic  of  this  poison- 
ing, since  they  occur  in  poisoning  by  other  agents,  as 
ammonia,  arsenic,  alcohol,  antimony,  etc.,  and  also  as  the 
result  of  disease ;  nevertheless,  they  possess  especial  im- 
portance from  their  association  with  other  notable  symp- 
toms of  phosphorus-poisoning,  such  as  the  jaundice,  mus- 
cular pains  and  weakness,  diseased  condition  of  the  blood, 
and  albuminous  urine. 

The  contents  of  the  stomach  in  some  instances  evolve  the 
odor  and  white  fumes  of  phosphorus;  and  in  a  case  men- 
tioned by  Casper,  two  days  after  death  luminous  vapors 
issued  from  the  vagina,  and  a  whitish  vapor  having  a  phos- 
phorous odor  issued  from  the  anus.  In  this  instance,  no 
smell,  or  vapor  of  phosphorus  could  be  detected  on  opening 


PHOSPHORUS — CHEMICAL   ANALYSIS.  2*29 

the  stomach  ;  nor  was  there  any  part  of  its  lining  mem- 
brane either  softened  or  corroded. 

Diagnosis. — Generally,  in  acute  cases,  there  will  be  no 
difficulty  in  recognizing  the  evidences  of  phosphorus-poi- 
soning, both  from  the  symptoms  and  post-mortem  lesions, 
as  above  detailed.  Chronic  cases,  accompanied  by  jaun- 
dice, might,  however,  be  mistaken  for  yellow  atrophy  of  the 
liver.  The  following  are  diagnostic  points:  The  sensation 
of  heat  in  the  throat,  eructations  and  vomiting  of  matters 
having  a  garlicky  odor  and  a  luminous  appearance,  would 
indicate  phosphorus  poison.  The  icterode  appearance  is 
not  so  intense  in  the  poisoning  as  in  the  disease,  nor  is  it 
accompanied  with  the  injection  of  the  eyes,  or  with  the  fever, 
which  mark  the  latter.  The  fatty  change  of  the  viscera 
may  be  seen  two  days  after  the  ingestion  of  the  poison 
(Tardieu).  According  to  other  authorities,  the  liver  in 
phosphorus-poisoning  is  enlarged,  of  a  dull  appearance, 
doughy,  uniformly  yellow,  with  the  acini  well  marked  ;  in 
acute  atrophy,  the  liver  is  diminished  in  size,  greasy  on  the 
surface,  of  a  dirty  yellow  color,  and  the  acini  nearly 
obliterated.  In  the  former,  also,  the  hepatic  cells  are  either 
filled  with  oil  globules,  or  entirely  replaced  by  them  ;  in  the 
latter,  the  cells  are  filled  with  a  fine  granular  detritus  and 
thin  structure,  replaced  by  a  newly-formed  connective 
tissue  (Husband). 

Cliemieal  analysis. — Phosphorus  is  a  white,  waxy  solid  ; 
sp.  gr.  1.83;  fuses  at  i  io°  F. ;  at  a  higher  temperature  it 
takes  fire,  burning  with  a  brilliant  white  light,  becoming 
converted  into  the  white  fumes  of  anhydrous  phosphoric 
acid.  It  evolves  white  fumes  of  phosphorous  acid  at  ordinary 
temperatures,  when  exposed  to  the  air,  which  also  appear 
luminous  in  the  dark.  The  smell  and  taste  of  phosphorus 
resemble  those  of  garlic,  by  which  means  it  may  be  easily 


230  TOXICOLOGY. 

recognized  when  mixed  with  food  and  drinks.  The  fuming 
of  phosphorus  in  the  air,  as  also  its  luminosity,  is  completely 
prevented  by  the  presence  of  alcohol,  ether,  chloroform,  oil 
of  turpentine  and  ammonia,  even  in  minute  quantities. 
Although  insoluble  in  water,  phosphorus  imparts  to  it 
poisonous  properties,  from  the  production  of  phosphorous 
acid.  It  is  tolerably  soluble  in  fixed  and  volatile  oils,  by 
the  aid  of  heat ;  also  in  ether,  chloroform  and  naphtha  ;  its 
best  solvent  is  bisulphide  of  carbon.  Nitric  acid  converts  it 
into  phosphoric  acid.  It  is  not  affected  by  either  sulphuric 
or  hydrochloric  acids.  It  is  best  preserved  under  water,  to 
protect  it  from  oxidation. 

In  its  free  state,  phosphorus  is  easily  detected  by  its 
sensible  properties,  as  already  described.  A  fragment  put 
into  the  materials  for  generating  hydrogen  will  evolve  phos- 
phoretted  hydrogen,  easily  recognized  by  its  luminosity  in  the 
dark,  and  from  being  sometimes  spontaneously  inflammable; 
this  gas,  when  ignited  at  a  jet,  burns  with  a  greenish-blue 
flame.  When  it  is  passed  through  a  solution  of  nitrate  of 
silver,  the  latter  is  blackened  by  the  production  of  metallic 
silver,  and  phosphoric  acid  is  formed  in  the  solution,  and 
may  be  detected  by  the  appropriate  reagents. 

Toxicological  examination. — If  the  materials  evolve  whitish 
fumes,  which  are  luminous  in  the  dark  and  have  an  allia- 
ceous odor,  there  can  be  no  doubt  of  the  presence  of  phos- 
phorus. If  the  mixture  be  ammoniacal,  from  putrefaction, 
sulphuric  acid  must  first  be  added,  to  neutralize  the  ammo- 
nia, since  this  would  prevent  the  display  of  luminosity. 
Sometimes  the  particles  of  phosphorus  may  be  separated 
mechanically  from  the  inside  of  the  stomach  and  bowels, 
which,  when  found,  should  be  carefully  washed  and  set 
aside.  Or,  the  mass  may  be  spread  out  on  a  metallic  plate, 
and  gently  heated  over  a  spirit  lamp,  when  the  minute  frag- 


PHOSPHORUS — TOXICOLOGICAL   EXAMINATION.  231 

merits  of  phosphorus  will  take  fire  and  burn  with  a  brilliant 
light.  The  suspected  particles  may  be  heated  under  water, 
when  they  will  melt  and  run  together  into  a  globule,  which 
will  solidify  on  cooling,  and  may  easily  be  identified. 

Bisulphide  of  carbon  may  be  used  to  dissolve  out  the 
phosphorus  from  many  organic  mixtures,  as  when  phos- 
phorus paste  has  been  employed.  On  allowing  the  solution 
to  evaporate  spontaneously,  the  phosphorus  will  remain  in 
minute  globules,  which  can  readily  be  examined.  If,  how- 
ever, the  poison  is  in  solution,  or  in  too  minute  a  quantity 
for  the  above  tests,  it  must  be  examined  by  the  following 
processes : — 

Method  of  Mitscherlicli. — The  suspected  liquid,  acidified 
by  sulphuric  acid,  is  to  be  distilled  in  the  dark,  and  the 
vapors  conducted  through  a  long  glass  tube,  kept  cold,  the 
end  of  which  passes  into  a  receiver.  On  gently  heating  the 
retort  or  flask,  the  vapors,  as  they  pass  through  the  cold 
tube,  condense  and  display  a  distinct  luminosity.  The  phos- 
phorus thus  distilled  collects  with  the  aqueous  vapor  in 
the  receiver,  to  which  it  imparts  the  usual  garlicky  odor. 
A  portion  of  it  may  likewise  collect  in  the  receiver  in  the 
form  of  globules.  This  test  is  exceedingly  delicate  and 
satisfactory.  Dr.  Taylor  states  that  the  head  of  one  lucifer 
match  produced  a  luminosity  which  continued  for  half  an 
hour,  in  the  condensing  tube.  We  have  ourselves  verified 
this,  by  experimenting  with  a  granule  containing  the  ~h  of  a 
grain  of  phosphorus,  with  satisfactory  results. 

The  presence  of  solid  phosphorus  in  the  distillate  would 
render  further  experiments  unnecessary;  but  in  the  absence 
of  any  granules,  the  distillate,  after  filtration,  should  be 
acidified  by  nitric  acid,  which  will  convert  any  phosphorus 
into  phosphoric  acid;  the  liquid  should  then  be  concentrated 
by  evaporation,  and  tested  (see  post.)     If  no  luminosity  has 


232  TOXICOLOGY. 

been  observed,  the  presence  of  a  small  amount  of  the 
oxides  of  phosphorus  in  the  distillate  is  not  sufficient  to 
warrant  the  supposition  of  poison,  since  these  might  have 
been  derived  from  the  food  or  tissues,  and  carried  over 
mechanically.  It  should  be  remembered  that  it  is  only 
free  phosphorus  that  gives  out  the  luminosity  by  the 
above  process;  the  distillation  of  the  brain,  or  -any  other 
tissue  that  contains  this  substance  in  combination,  never 
produces  it. 

Method  of  Lipowitz. — This  consists  in  boiling  the  sus- 
pected liquid,  slightly  acidulated  with  sulphuric  acid,  with 
fragments  of  sulphur,  in  an  apparatus  similar  to  that  em- 
ployed in  the  method  of  Mitscherlich,  the  experiment  being 
conducted  in  the  dark.  The  sulphur  abstracts  the  phos- 
phorus from  even  complex  mixtures,  and  combines  with  it. 
The  boiling  is  continued  for  about  half  an  hour,  after  which 
the  pieces  of  sulphur  are  withdrawn  and  washed  in  water. 
The)'  will  now  emit  the  peculiar  odor  of  phosphorus,  and 
appear  luminous  in  the  dark.  On  gently  heating  them 
with  nitric  acid,  a  mixture  of  phosphoric  and  sulphuric  acids 
will  result.  By  evaporating  this  solution  to  near  dryness, 
to  get  rid  of  the  sulphuric  acid,  then  diluting  and  filtering, 
the  phosphoric  acid  may  be  recognized  by  the  usual  tests. 
In  prosecuting  this  test,  unless  the  amount  of  phosphorus 
is  very  minute,  the  luminosity  of  the  vapor  may  also  be  ob- 
served in  the  cool  tube. 

The  hydrogen  method. — This  process  resembles  the 
method  oi  Marsh  employed  in  arsenic  testing.  The  sus- 
pected material,  properly  prepared,  is  put  into  the  jar  con- 
taining the  materials  for  generating  hydrogen;  the  resulting 
gas  is  then  passed  over  hydrate  of  lime,  for  the  purpose  of 
removing  any  sulphuretted  hydrogen;  it  is  then  ignited  at 
the  end  of  the  delivery  tube,  producing  a  green  flame.    The 


PHOSriIORIC    ACID TESTS.  233 

phosphorctted  hydrogen  is  luminous  in  the  dark,  and  affords 
a  black  precipitate  with  nitrate  of  silver. 

Phosphorus  has  been  detected  in  the  free  state  as  late  as 
fourteen  days,  and  three  weeks  after  death;  but  it  is  very 
apt  soon  to  become  oxidized  in  the  body,  in  which  case  it 
can  only  be  identified  as  phosphoric  acid. 

The  method  of  testing  for  phosphorus,  or  phosphoric  acid, 
in  a  case  of  suspected  poisoning,  is  very  unsatisfactory,  since 
this  acid  exists  in  combination  with  the  tissues  and  secre- 
tions, as  well  as  in  many  articles  of  food. 

The  mode  of  procedure  in  such  a  case  is  to  treat  the 
mixture  with  a  little  pure  nitric  acid,  and  concentrate  by 
evaporation.  It  is  then  treated  with  a  slight  excess  of  pure 
carbonate  of  sodium  and  evaporated  to  dryness,  and  fused 
in  a  porcelain  crucible.  The  resulting  phosphate  of  sodium 
may  then  be  tested  as  follows  : — 

(i)  Nitrate  of  silver  throws  down  a  yellow  tribasic  phos- 
phate of  silver,  soluble  in  ammonia,  and  in  nitric  and  acetic 
acids.  Hydrochloric  acid  converts  it  into  the  white  chloride. 
Nitrate  of  silver  also  gives  a  yellow  precipitate  with  arsenious 
acid,  which  behaves  in  the  same  manner  as  the  phosphate  ; 
they  are  distinguished  by  drying,  and  heating  in  a  reduction 
tube;  the  arsenic  yields  a  ring  of  sublimed  octahedral  crys- 
tals {vid.  post,) 

(2)  Ammouio-sulphatc  of  magnesia. — This  compound 
gives  with  a  phosphate  a  characteristic  crystalline  precipi- 
tate— the  ammonia-phosphate  of  magnesia;  the  minutest 
quantity  can  be  identified  by  the  microscope. 

(3)  Molybdate  of  ammonia. — This  reagent  produces  a 
yellow,  pulverulent  precipitate — the  phospho-molybdate  of 
ammonia  ;  it  is  insoluble  in  the  strong  acids,  but  soluble  in 
alkaline  phosphates,  alkalies  and  alkaline  carbonates. 

Red,  Amorphous,  or  Allotropic  Phosphorus. — This  singular 
1 1* 


234  TOXICOLOGY. 

variety  of  phosphorus  is  procured  by  exposing  ordinary 
phosphorus  to  a  heat  of  4500  F.,  in  an  atmosphere  deprived 
of  oxygen  (as  in  carbonic  acid  gas)  for  a  number  of  hours, 
when  it  will  have  changed  into  a  hard,  brick-red  mass, 
totally  unlike  the  ordinary  substance  in  its  chemical,  phy- 
sical and  physiological  properties,  although  retaining  its 
original  chemical  composition.  The  difference  between  the 
two  is  shown  by  reference  to  the  following  table,  taken  from 
Dr.  Percy's  essay  above  referred  to : — 

COMMON   PHOSPHORUS.  RED   PHOSPHORUS. 

Poisonous.  Innocuous. 

Evolves  a  strong  odor.  Nearly  odorless. 

Phosphorescent.  Not  phosphorescent. 

Melts  at  1080  F.  Melts  at  about  5000  F. 

Transparent.  Opaque. 

Almost  colorless.  Varies    in    color   from  a   reddish- 

black  to  crimson. 

Freely  soluble  in  various  liquids.     Nearly  insoluble  with  liquids. 

Distinctly  crystalline.  Amorphous. 

Soft  and  waxy.  Hard  as  red  brick. 

Flexible.  Brittle  as  glass. 

Oxidizes  in  the  air.  I  nalterable  in  the  air. 

Unites  readily  with  other  elements.  Is  acted  on  by  other  elements  with 

difficulty. 

Nitric  acid  acts  on  it  with  great    Produces  no  effect, 
energy. 

SECTION  II. 
POISONING  BY  IODINE,  BROMINE  AND  CHLORINE. 

Iodine  occurs  in  shiny,  dark  iron-gray  scales;  it  has  a  pe- 
culiar odor  and  disagreeable  taste;  when  heated  it  gives  off 
beautiful  violet-colored  fumes,  which  are  irritating  to  the 
nostrils  and  throat.  Sparingly  soluble  in  water,  very 
soluble    in    alcohol    and    ether,   and    also   in    the  aqueous 


POISONING    BY    IODINE.  235 

solution  of  iodide  of  potassium.  It  is  used  medicinally  in 
the  form  of  tincture,  compound  tincture  and  ointment. 

Symptoms. — Like  phosphorus,  iodine  produces  a  local 
irritant  effect,  and  a  remote  influence;  the  latter,  the  result 
of  using  it  in  small  quantities.  In  large  doses  it  occasions 
burning  heat  in  the  throat;  severe  pain  in  the  abdomen; 
vomiting  and  purging,  the  vomited  matters  having  the  pe- 
culiar odor  of  iodine,  sometimes  mixed  with  blood ;  the 
color  of  the  matters  is  yellowish,  except  when  they  consist 
of  farinaceous  articles,  in  which  case  it  is  blue.  The  bowels 
may  also  exhibit  the  presence  of  iodine.  Other  symptoms  are 
giddiness,  headache,  thirst,  anxiety,  convulsions  and  fainting. 

In  chronic  poisoning  {iodism)  the  symptoms  are  nausea, 
vomiting,  purging,  pain  of  stomach,  tremors,  palpitation, 
salivation,  cramps,  general  emaciation,  and  a  tendency  to 
absorption  of  certain  glands,  especially  the  testes  of  males, 
and  the  mamms  of  females. 

There  is  a  remarkable  diversity  in  the  effects  of  iodine 
upon  the  human  system,  some  persons  bearing  very  large 
doses  with  little  or  no  suffering,  while  others  are  seriously 
affected  by  the  smallest  quantities.  Overdoses  have  occa- 
sionally proved  fatal,  leaving  morbid  appearances  very 
similar  to  those  produced  by  the  irritant  alkaline  salts. 

Chemical  cuialysis. — In  its  free  state,  iodine  may  readily 
be  distinguished  by  its  solid  form,  color,  odor,  volatility,  and 
its  action  on  boiled  starch — quickly  turning  it  blue.  In 
combination,  as  iodide  of  potassium,  the  iodine  must  first  be 
set  free  (by  chlorine,  or  nitric  acid)  and  then  the  starch-test 
applied. 

From  organic  mixtures  the  iodine  may  be  separated  by 
bisulphide  of  carbon,  which  dissolves  it,  forming  a  pink 
solution ;  remove  the  watery  liquid,  and  evaporate  the 
bisulphide  solution  to  dryness,  when  the  iodine  will  be  left. 


236  TOXICOLOGY. 

If  this  process  fails,  on  account  of  the  conversion  of  the 
iodine  into  hydriodic  acid,  or  into  an  iodide,  it  will  be 
advisable  to  transmit  sulphuretted  hydrogen  through  the 
mass,  properly  diluted  ;  this  will  convert  any  free  iodine  to 
hydriodic  acid ;  drive  off  the  excess  of  gas  by  heat ;  add 
potash  in  excess  ;  filter  and  evaporate  to  dryness.  Char  the 
residue  at  a  low  red  heat,  to  get  rid  of  the  organic  matter ; 
pulverize  and  dissolve  in  water.  Concentrate  the  solution, 
and  add  strong  nitric  acid  and  boiled  starch,  which  will 
develop  the  iodine,  if  any  be  present. 

Iodide  of  Potassium. — Although  much  used  in  medicine, 
in  doses  up  to  sixty  grains  it  occasionally  produces  violent 
effects  upon  the  system,  such  as  headache,  griping  abdomi- 
nal pains,  thirst,  inflammation  of  the  nostrils  and  eyes,  and 
frequent  pulse,  together  with  salivation,  and  a  pustular 
eruption.  As  found  in  the  shops,  the  salt  is  apt  to  be  con- 
siderably adulterated  with  the  carbonate. 

Bromine. — This  is  a  dark  red,  volatile  liquid,  excessively 
pungent  to  the  eyes  and  respiratory  organs,  having  an  acrid 
odor  and  taste.  It  is  highly  corrosive,  destroying  animal 
tissues  very  rapidly.  It  has  occasionally  proved  poisonous 
fatally.  A  case  is  reported  by  Dr.  Sayre,  of  New  York,  of 
a  daguerreotyper,  who  swallowed  an  ounce  of  bromine  for 
the  purpose  of  self-destruction.  The  immediate  symptoms 
were  spasmodic  action  of  the  muscles  of  the  larynx  and 
pharynx,  with  great  difficulty  of  breathing,  followed  by  in- 
tense burning  pain  in  the  stomach,  with  great  anxiety,  rest- 
lessness and  trembling  of  the  hands.  The  pulse  was  rapid, 
tense  and  corded,  and  respiration  greatly  hurried.  Collapse 
soon  followed,  and  death  took  place  in  seven  and  a  Jialf 
hours  after  swallowing  the  poison. 

The  post-mortem  examination  revealed  vivid  injection  of 


POISONING    BY    BROMINE    AND    CHLORINE.  237 

the  external  coat  of  the  stomach  and  of  the  abdominal 
viscera  generally,  which  were  stained  of  a  deep  yellow 
color.  Portions  of  the  stomach  were  softened.  Its  con- 
tents resembled  port-wine  dregs,  and  exhaled  the  odor  of 
bromine.  Its  whole  interior  was  covered  with  a  thick  black 
layer  resembling  coarse  tanned  leather.  The  mucous  mem- 
brane was  very  thin  and  very  deeply  injected  (Whar.  and 
Stilles  Med.Jurisp.  from  N.  York  Jour,  of  Med ,  Nov.  1850). 
Chemical  analysis. —  Bromine  may  be  separated  from 
organic  matters  by  means  of  bisulphide  of  carbon,  or  by 
ether,  after  the  method  described  for  iodine  (p.  235).  The 
bromides  may  be  decomposed  by  chlorine,  or  by  a  strong 
acid.  Bromine  is  characterized  by  imparting  a  deep  yellozv 
color  to  boiled  starch. 

Chlorine  is  a  powerfully  irritating  gas,  of  a  greenish - 
yellow  color.  If  inhaled  into  the  lungs  it  may  destroy  life, 
like  gaseous  ammonia.  Chlorine  is  readily  recognized  by 
its  smell  and  color,  and  especially  by  its  powerful  bleaching 
properties. 


TOXICOl  OGY. 


CHAPTER    XVII. 

POISONING  BY  ARSENIC. 

M  II  A  LLIC  ARSENIC.  —  ARSEXIOUS  ACID.  —  PROPERTIES.  —  SYMP- 
TOMS.— CHRONIC  POISONING. — FATAL  DOSE. — TREATMENT. — POST- 
MORTEM SIGNS. — CHEMICAL  ANALYSIS. — TOXICOLOGICAL  EXAMI- 
NATION.— OTHER    PREPARATIONS    OF   ARSENIC. 

The  term  arsenic,  as  employed  in  toxicology,  always 
signifies  (unless  specially  qualified)  arsenious  acid,  or  white 
oxide  of  arsenic.  The  metal  is  brittle,  of  a  steel-gray  color, 
very  volatile  when  heated,  its  vapor  having  a  strong,  garlicky 
odor,  by  which  it  is  easily  recognized.  It  is  very  rarely 
used  as  a  poison ;  it  is  sold,  however,  under  the  name  oifiy 
powder \  which  is  a  mixture  of  the  metal  and  arsenious  acid. 

Arsenic  is  one  of  the  most  important  of  all  the  poisons. 
The  facility  of  procuring  it,  and  its  ease  of  administration 
contribute  greatly  to  its  extensive  use,  both  as  a  homicidal 
and  suicidal  agent.  Arsenic  exists  in  nature  in  the  form  of 
the  metal,  and  in  combination  with  other  metals,  particularly 
iron,  copper,  zinc,  nickel  and  cobalt ;  also  with  sulphur,  as 
native  orpitnent  and  realgar. 

In  the  arts,  arsenic  enters  into  numerous  compounds,  as 
in  the  manufacture  of  enamel  and  glass,  composition  can- 
dles, vermin  killers,  etc.  It  is  used  by  shipbuilders  to  pro- 
tect timber  from  worms ;  by  farmers  to  preserve  their  grain 
for  seed  and  for  washing  sheep ;  by  grooms  to  improve  the 
(••ats  of  their  horses;  and,  if  we  may  credit  the  accounts  of 
travelers,  by  the  inhabitants  of  Styria  and  other  mountain- 
ous countries,  to  increase  their  physical  powers  of  endurance 
and  to  improve  the  complexion  of  the  females. 


POISONING    BY    ARSENIC SYMPTOMS.  239 

Properties  of  Arsenious  Acid,  AsOa. — It  occurs  in  com- 
merce either  as  a  heavy,  white  powder,  or  in  masses,  which 
are  at  first  translucent,  but  afterwards  become  opaque.  It  is 
nearly  tasteless,  or  at  most  has  a  faint  sourish  taste,  not 
acrid.  It  is  only  slightly  soluble  in  cold  water  ;  boiling- 
water  dissolves  about  the  eighteenth  to  the  fortieth  part  of 
its  weight,  or  from  six  to  twelve  grains  to  the  ounce.  Cold 
water  takes  up  only  about  half  a  grain  to  the  ounce.  Its 
solubility  is  much  increased  by  the  addition  of  an  alkali,  but 
diminished  by  the  presence  of  organic  matter.  It  is  easily 
held  in  suspension  by  soups,  coffee,  tea,  milk,  etc. 

When  arsenious  acid  is  heated  at  a  temperature  near  4000 
F.,  it  sublimes  in  the  form  of  a  white  vapor,  which  is 
inodorous,  and  is  deposited  on  a  cool  surface,  either  as  an 
amorphous  powder,  or  in  octahedral  crystals.  If  thrown 
upon  red-hot  charcoal  it  is  decomposed,  and  the  vapor  will 
have  an  alliaceous  odor,  because  it  results  from  the  reduced 
metal. 

Symptoms. — The  rapidity  and  virulence  of  the  symptoms 
depend  somewhat  on  the  form  of  the  poison  [i.  e.y  whether 
in  solution  or  otherwise),  and  also  on  the  fullness  or  empti- 
ness of  the  stomach.  As  a  rule,  the  symptoms  do  not 
occur  for  half  an  hour,  or  an  hour.  There  is  first  a  sense  of 
faintness,  attended  with  a  feeling  of  heat  and  constriction  of 
the  throat,  together  with  thirst,  nausea  and  burning  pain  in 
the  stomach,  increased  by  pressure.  Vomiting  and  retch- 
ing soon  follow;  the  matters  ejected  are  sometimes  streaked 
with  blood ;  they  may  be  variously  colored.  Purging, 
accompanied  with  tenesmus,  comes  on,  and  along  with  the 
vomiting,  may  be  incessant,  though  affording  no  relief  to 
the  sufferer.  Cramps  in  the  legs  are  apt  to  be  present, 
along  with  great  depression,  cold  sweat,  intense  thirst,  and 
a  feeble,  frequent    pulse.     The    whole   train   of  symptoms 


240  TOXICOLOGY. 

strongly  resembles  a  severe  case  of  cholera  morbus,  for 
which  it  has  frequently  been  mistaken.  As  a  rule,  the 
symptoms  are  continuous,  although  there  are,  occasionally, 
remissions,  and  even  intermissions.  Coma,  paralysis  and 
convulsions  may  supervene  before  death.  The  urine  is  often 
partially  suppressed.  If  the  patient  recovers  from  the  im- 
mediate attack,  he  may  suffer  for  a  long  time  after  from 
indigestion,  partial  paralysis,  or  from  epilepsy. 

Certain  anomalies  may  occur.  The  pain  may  be  absent  or 
slight.  Vomiting  and  purging  and  thirst  may  not  be 
present.  Some  cases  especially  resemble  cholera  morbus, 
from  the  intensity  of  the  gastro-enteric  irritability;  whilst 
others  indicate  severe  nervous  disturbance,  by  the  intense 
headache,  giddiness,  restlessness,  violent  cramps,  delirium, 
convulsions  and  coma.  Again,  there  may  be  immediate 
collapse,  little  or  no  pain,  vomiting  or  purging,  but  a  cold, 
clammy  skin,  extreme  prostration,  very  frequent  and  feeble 
pulse,  slight  coma,  with  perhaps  convulsions  and  death 
within  a  few  hours  after  swallowing  the  poison.  In  yet 
other  instances,  the  symptoms  resemble  those  of  narcotics, 
the  person  falling  into  a  profound  sleep,  deepening  into 
coma,  and  dying  in  a  few  hours  without  rallying.  In  the 
latter  eases,  the  autopsy  has  revealed  no  trace  of  inflamma- 
tion of  the  stomach. 

All  the  above  varieties  of  symptoms  occur  quite  inde- 
pendently of  the  size  of  the  dose,  or  mode  of  administration, 
and  they  cannot  be  satisfactorily  explained  except  by 
referring  them  to  constitutional  peculiarities. 

The  symptoms  of  chronic  poisoning  usually  result  from 
small  doses  of  arsenic  frequently  repeated,  or  from  exposure 
to  the  vapors  of  arsenical  products,  as  in  the  case  of  work- 
men, or  from  the  accidental  inhalation  of  arsenical  dust 
from  wall  papers.     The  eyes  become  inflamed  and  watery, 


ARSENIC — EXTERNAL   APPLICATION.  241 

there  is  great  gastric  distress,  with  frequent  sickness  and 
vomiting,  diarrhoea,  headache  and  giddiness,  a  jaundiced 
skin,  an  eczematous  eruption,  local  paralysis,  general 
emaciation,  falling  out  of  the  hair,  salivation  and  excoria- 
tion of  the  tongue,  with  hemorrhage;  and  death  may  occur 
from  exhaustion.  The  symptoms  in  such  a  case  are  fre- 
quently very  obscure  and  misleading,  and  perhaps  .chance 
alone  may  reveal  the  real  source  of  the  disorder. 

The  time  when  the  symptoms  appear  varies  considerably. 
As  before  stated,  these  do  not  generally  manifest  themselves 
for  a  half  hour  or  an  hour  after  swallowing  the  poison,  but 
there  are  numerous  exceptions.  Cases  are  recorded  where 
they  appeared  in  the  act  of  swallowing ;  others,  in  which 
they  were  exhibited  in  eight,  ten  and  fifteen  minutes  after. 
On  the  other  hand,  numerous  instances  are  recorded  where 
the  time  was  protracted  for  many  hours.  The  longest  in- 
terval is  mentioned  in  the  U.S.  Dispensatory  (1865),  where 
the  symptoms  were  delayed  for  sixteen  Jiours,  after  a  dose  of 
a  drachm  of  the  poison.  This  discrepancy  may,  in  part,  be 
accounted  for  by  the  state  of  the  stomach,  it  being  empty 
or  full  at  the  time'  of  administration  ;  also  by  the  form  of 
the  dose,  whether  solid  or  liquid ;  also  by  the  time  of 
day,  whether  before  going  to  sleep,  or  otherwise.  The 
simultaneous  use  of  opium  or  alcohol  would,  no  doubt, 
exercise  a  modifying  influence  over  this  poison.  (See  ante, 
p.  186.) 

The  external  application  of  arsenic,  either  to  the  sound 
skin,  or  still  more  to  abraded  or  ulcerated  surfaces,  is  often 
followed  by  fatal  results.  Proofs  of  this  are  exhibited  in  the 
effects  of  the  applications  of  cancer-carers  to  ulcerated 
breasts  ;  also  in  the  use  of  arsenical  solutions  to  the  sore 
heads  of  children.  In  some  of  these  instances,  absorbed 
arsenic  has  been  detected,  after  death,  in  the  viscera  of  the 


2A2  TOXICOLOGY. 

body.     Arsenic  has  also  proved  fatal  when  injected  into  the 
rectum  and  vagina. 

In  all  the  above  cases  of  the  external  application  of 
this  poison,  its  usual  constitutional  effects  were  produced, 
such  as  burning  and  constriction  of  the  throat,  thirst,  vomit- 
ing and  purging,  great  depression,  and  the  various  nervous 
disturbances  above  described. 

Fatal  dose. —  Two  grains  maybe  considered  the  minimum 
fatal  dose  for  an  adult,  but  smaller  quantities  have  pro- 
duced alarming  symptoms.  On  the  other  hand,  recoveries 
have  often  occurred  after  very  large  doses — one  to  two 
ounces — have  been  swallowed. 

Fatal  period. — The  great  majority  of  deaths  occur  within 
twenty-four  hours,  and  of  these  the  most  within  eight  or  ten 
hours.  The  shortest  period  is  recorded  by  Dr.  Taylor,  of  a 
youth,  aged  seventeen  years,  who  died  in  twenty  minutes 
from  the  effects  of  a  large  dose  accidentally  swallowed  ;  the 
symptoms  were  of  a  tetanic  character.  Other  cases  are  re- 
ported where  death  occurred  in  two  or  three  hours.  On  the 
other  hand,  life  may  be  prolonged  for  weeks ,  months  or  even 
years,  the  patient  suffering  greatly  during  the  whole  interval. 

Arsenic  is  not  a  cumulative  poison  ;  it  is  temporarily  de- 
posited in  the  liver  and  other  organs  of  the  body  after  ab- 
sorption, but  it  is  rapidly  eliminated  from  the  system  by  the 
urine,  bile  and  other  secretions.  Should  the  person  sur- 
vive for  two  or  three  weeks,  no  trace  of  the  poison  may  be 
found  after  his  death,  in  consequence  of  its  total  elimination 
during  the  interim.  The  exact  period  at  which  arsenic  is 
completely  eliminated  from  the  hu  man  system  is  not  fixed, 
but  the  analyst  need  hardly  expect  to  discover  it  after  sixteen 
days,  although  it  has  been  detected  in  the  urine  of  a  man 
twenty-one  days  after  swallowing  a  large  dose,  and  who 
subsequently  recovered. 


ARSENIC — POST-MORTEM    APPEARANCES.  2  13 

The  rapidity  with  which  it  is  absorbed  and  deposited  in 
the  tissues  is  very  great.  Dr.  Taylor  (On  Poisons,  p.  46) 
found  it  in  the  liver  four  hours  after  it  had  been  swallowed. 
He  believes  that  the  liver  acquires  its  maximum  of  absorbed 
arsenic  (about  two  grains)  in  fifteen  hours,  after  which  the 
quantity  gradually  diminishes. 

The  question  of  the  elimination  of  arsenic  from  the  human 
system  may  have  an  important  medico-legal  bearing,  as 
where  a  person  who  has  been  taking  small  doses  of  arsenic, 
medicinally,  for  a  length  of  time,  should  suddenly  die  from 
gastro-enteritis,  and  a  post-mortem  examination  should 
reveal  the  presence  of  absorbed  arsenic  in  the  organs.  Here 
both  the  symptoms  and  the  chemical  analysis  would 
strongly  confirm  the  suspicion  of  arsenical  poisoning,  unless 
the  fact  of  the  medicinal  administration  of  the  drug  could  be 
satisfactorily  established. 

Arsenic  is  known  to  be  deposited  in  all  the  tissues  of  the 
body,  including  the  bones  ;  but  not  in  the  hair. 

Post-mortem  appearances. — The  most  decided  evidences  of 
the  irritant  character  of  the  poison  are  exhibited  by  the 
stomach,  the  mucous  lining  of  which  is  usually  highly 
inflamed,  sometimes  presenting  a  uniform,  deep  red  color, 
at  others,  showing  patches  of  diffused  dark  redness.  Arsenic 
seems  to  have  a  specific  effect  on  the  stomach,  no  matter  by 
what  avenue  it  is  introduced  into  the  system.  Occasionally, 
the  lining  membrane  is  thickened  and  corrugated ;  a^ain,  it 
is  softened,  and  readily  separated.  When  the  poison  has 
been  taken  in  substance,  it  is  not  unusual  to  find  patches 
several  inches  in  extent,  consisting  of  tough,  yellowish- 
white  bases  of  arsenious  acid,  mixed  with  lymph  and  mucus, 
firmly  adherent  to  the  membrane,  and  forming  so  man}'  foci 
of  intense  inflammation.  White  spots  of  arsenic  are  often 
found    between  the  ruga:,   and  when   a   long  interval   Iris 


244  TOXICOLOGY. 

occurred  before  the  examination,  yellow  stains  may  be 
found,  as  the  result  of  a  decomposition  into  the  yellow 
sulphide. 

Ulceration  of  the  stomach  is  rare;  but  we  have  witnessed 
it  in  two  instances,  one  quite  recently,  where  death  occurred 
in  eight  hours  after  swallowing  the  poison  ;  in  the  other 
case  the  examination  was  not  made  until  four  months  after 
death  ;  here  the  ulcer  was  a  quarter  of  an  inch  in  diameter, 
and  was  surrounded  by  a  deep  zone  of  dark,  effused  blood, 
and  had  penetrated  down  to  the  peritoneal  coat  of  the 
stomach.     Perforation  is  still  more  rare. 

The  upper  portion  of  the  small  intestine  is  very  apt  to  be 
involved  in  the  inflammation  ;  also  the  caecum  and  rectum. 
Other  organs,  as  the  lungs,  brain  and  bladder,  are  occasion- 
ally found  congested  ;  but  these  offer  no  diagnostic  points. 
The  most  remarkable  fact  connected  with  the  post-mortem 
appearances  is  the  occasional  absence  of  all  signs  of  inflam- 
mation, even  in  cases  where  there  had  been  violent 
inflammatory  symptoms  before   death. 

An  important  circumstance  is  the  antiseptic  power  of 
arsenic,  which  accounts  for  the  remarkable  preservation  of 
the  body  for  many  months  after  death,  whereby  the  detec- 
tion of  the  poison  is  possible  for  a  long  period  after  burial — 
in  one  case,  fourteen  years  after  death.  Of  course,  after  such 
an  interval,  most  of  the  body  would  be  decomposed,  but 
still  enough  remains  for  the  purpose  of  identification.  In 
such  cases  there  is  generally  noticed  an  absence  of  the  usual 
cadaveric  odor,  and  also  the  presence  of  numerous  yellow 
patches  over  the  abdominal  viscera,  due  to  the  production 
of  the  yellow  sulphide,  by  the  action  of  sulphuretted  hy- 
drogen on  the  arsenious  acid. 

It  should,  however,  be  stated  that  arsenic  does  not  uni- 
formly exert  this  preservative  power  on  a  dead  body;  in  fact, 


ARSENIC — CHEMICAL   ANALYSIS.  245 

in  some  cases  it  would  seem  that  putrefaction  has  advanced 
with  increased  rapidity.  These  instances,  however,  are  ex- 
ceptional; but  they  should  put  the  expert  on  his  guard 
against  too  positive  an  assertion  as  to  the  presence  of  ar- 
senic when  a  body  exhibits  an  unusual  degree  of  preserva- 
tion, since  this  may  be  due  to  other  causes  (vid.  ante  p.  53). 

Treatment. — If  vomiting  is  not  active,  a  quick  emetic  (sul- 
phate of  zinc  and  ipecac)  should  be  administered,  or  a  draught 
of  mustard  water;  the  stomach  pump  may  be  employed,  if 
on  hand;  warm  diluent  drinks  are  useful ;  after  this,  the  free 
use  of  hydrated  sesquioxide  of  iron.  This  can  be  prepared 
extemporaneously  by  diluting  the  tincture  of  the  chloride 
and  adding  ammonia  in  excess,  and  washing  the  precipitated 
iron.  This  antidote  must  be  taken  in  large  doses,  frequently 
repeated.     Afterwards,  a  dose  of  castor  oil  should  be  given. 

There  are  numerous  attestations  to  the  value  of  this  anti- 
dote ;  it  acts  by  converting  the  poison  into  the  insoluble 
arsenate  of  iron.  The  freshly  precipitated  hydrate  of  magne- 
sia is  also  recommended  as  an  antidote. 

Chemical  Analysis. — I.  In  the  solid  state.  (1)  a  small 
quantity  of  the  white  powder  placed  on  platinum  foil  and 
heated  is  entirely  dissipated  in  white  inodorous  fumes;  (2) 
slowly  heated  in  a  narrow  glass  tube,  it  sublimes,  forming  a 
white  ring  of  octahedral  crystals  on  the  cool  portion  of  the 
tube,  visible  by  a  good  magnifier.  Calomel  and  corrosive 
sublimate  will  each  form  white  rings  under  similar  condi- 
tions; the  arsenical  deposit  is  distinguished  from  these  (a) 
by  the  octahedral  crystals ;  (/>)  by  the  action  of  liquor 
potassae,  which  dissolves  it  without  color,  while  it  gives  a 
black  color  to  calomel  and  a  yellowish-red  to  corrosive  sub- 
limate ;  (3)  moistened  with  sulphide  of  ammonium,  and 
evaporating,  produces  the  yellow  sulphide  ;  (4)  put  into  a 
reduction  tube  along  with  some  reducing  agent,  as  charcoal, 


246  TOXICOLOGY. 

black  flux,  or  dried  ferrocyanidc  of  potassium,  and  heated 
by  the  flame  of  a  spirit  lamp,  it  is  reduced,  and  the  metal 
is  volatilized  in  the  form  of  a  brilliant  steel-gray  ring  or 
mirror. 

In  order  to  effect  the  sublimation  successfully,  certain  pre- 
cautions are  necessary.  The  reduction  tube  should  be  small 
— about  the  eighth  of  an  inch  in  diameter,  and  three  inches 
long ;  it  should  be  perfectly  clean  and  free  from  moisture. 
The  reducing  agent  should  be  perfectly  dry,  and  thoroughly 
mixed  with  the  arsenious  acid,  in  the  proportion  of  three  or 
four  to  one  of  the  latter.  After  it  is  introduced  into  the 
tube,  this  should  be  wiped  out  with  a  wad  of  cotton  or  a  roll 
of  filtering  paper.  The  tube  should  first  be  gently  warmed 
just  above  the  contents,  and  then  fully  heated  in  the  flame. 
This  precaution  insures  a  better  formed  metallic  ring. 

For  the  sublimation  simply,  the  above  process  is  to  be 
pursued,  with  the  omission  of  the  reducing  agent. 

The  obtaining  the  metallic  ring  or  mirror,  by  the  reducing 
process,  may  be  regarded  as  positive  proof  of  the  presence 
of  arsenic ;  but  in  a  medico-legal  case  this  should  be  con- 
firmed by  further  proofs:  (i)  the  arsenic  mirror  is  wholly 
soluble  in  hypochlorite  of  sodium  ;  (2)  it  is  soluble  in  hot  nitric 
acid,  and  the  solution,  on  evaporation,  leaves  a  brick-red 
deposit  when  touched  with  nitrate  of  silver  solution,  due  to 
the  formation  of  arsenate  of  silver ;  (3)  if  the  closed  end  of 
the  tube  be  broken  off,  and  heat  applied  to  the  sublimate,  it 
will  readily  volatilize,  and,  combining  with  the  oxygen  of 
the  air,  will  condense  on  the  upper  portion  of  the  tube,  in  a 
white  ring  of  arsenious  acid ;  (4)  this  latter  maybe  dissolved 
in  a  few  drops  of  warm  water,  and  subjected  to  the  liquid 
tests. 

II.  The  liquid  tests. — These  are  the  ammonio-sulphate  of 
copper  and  the  ammonio-nitrate  of  silver.     They  should  be 


ARSENIC — CHEMICAL    ANALYSIS.  '217 

prepared  only  when  required  for  use.  The  former  is  made 
by  the  cautious  addition  of  aqua  ammoniae  to  a  somewhat 
dilute  solution  of  sulphate  of  copper,  until  the  precipitated 
oxide  is  barely  redissolved.  When  this  reagent  is  added  to 
a  solution  of  arsenious  acid,  it  throws  down  a  light  green 
arsenite  of  copper  (Scheele's  green).  This  precipitate  is 
soluble  in  ammonia,  and  in  free  acids.  If  the  arsenic  is  in 
very  minute  quantities,  the  characteristic  color  does  not 
appear  immediately. 

The  silver  test  is  prepared  by  adding  aqua  ammoniac  to  a 
strong  solution  of  nitrate  of  silver  until  the  precipitated 
oxide  is  barely  redissolved.  When  this  is  added  to  the 
arsenical  solution,  a.  canary-yellow  precipitate  occurs  (King's 
yellow),  arsenite  of  silver,  which,  like  the  former,  is  freely 
soluble  in  ammonia  and  the  acids. 

These  liquid  tests  are  available  only  in  perfectly  pure 
solutions  of  arsenious  acid ;  they  are  inadmissible  in  the 
presence  of  organic  matter,  e.g.,  the  contents  of  a  stomach, 
since  various  organic  substances  will  produce  similar  colors 
with  both  copper  and  silver.  They  may,  however,  be  satis- 
factorily confirmed  (i)  by  heating  either  of  the  dried  pre- 
cipitates (arsenite  of  copper  or  silver),  either  alone,  or  with  a 
reducing  agent,  in  a  reduction-tube  ;  the  former  experiment 
will  yield  a  sublimate  of  octahedral  crystals,  the  latter  the 
metallic  mirror.  (2)  If  the  blue  ammoniacal  solution  of 
the  arsenic  is  poured  over  a  crystal  of  nitrate  of  silver,  a 
film  of  yellow  arsenite  of  silver  is  immediately  formed 
around  it. 

III.  The  sulphuretted  hydrogen  test. — This  consists  in 
passing  washed  sulphuretted  hydrogen  gas  through  the 
solution  of  arsenious  acid,  slightly  acidified  by  hydrochloric 
acid  ;  a  clear,  yelloiv  precipitate  falls — tersulphide  of  arsenic 
(orpiment),  which  is  soluble  in  the  alkalies,  and  insoluble  in 


248  TOXICOLOGY. 

acids.  In  very  dilute  solutions,  the  precipitate  does  not 
separate  until  the  excess  of  the  gas  is  driven  off  by  heat. 

Fallacies. —  Cadmium,  tin  and  selenium  yield  somewhat 
similar  precipitates  with  sulphuretted  hydrogen.  Practically, 
the  only  one  that  need  be  considered  is  cadmium,  which, 
however,  is  easily  distinguished  from  arsenic,  as  follows  : 
(i)  the  arsenic  sulphide  is  soluble  in  ammonia  and  insoluble 
in  the  acids;  with  cadmium  sulphide  it  is  precisely  the 
reverse;  (2)  when  dried  and  sublimed  with  a  reducing 
agent,  the  arsenic  sulphide  yields  a  metallic  ring;  the 
cadmium,  a  brown  oxide. 

In  a  poison  case,  the  sulphide  of  arsenic  should  always 
be  proven  by  (1)  obtaining  the  metallic  ring  by  subliming  it 
with  a  reducing  agent;  (2)  by  boiling  the  sulphide  in  hydro- 
chloric acid,  along  with  a  piece  of  bright  copper  foil;  a  steel- 
gray  deposit  shows  the  presence  of  arsenic. 

IV.  Marsk s  Test. — The  principle  here  involved  is,  that 
when  arsenic  comes  in  contact  with  nascent  hydrogen,  it 
combines  with  it  to  form  arseuiureted hydrogen ',  a  gas  which 
possesses  peculiar  properties,  by  means  of  which  the  arsenic 
may  be  recognized  with  great  certainty.  Practically,  the 
simplest  and  best  mode  of  performing  the  experiment  is  to 
add  to  the  materials  for  generating  hydrogen  (zinc,  water 
and  sulphuric  acid),  in  a  wide-mouth  flask,  the  suspected  ar- 
senical solution.  The  cork  fitted  to  the  mouth  of  the  flask 
should  have  two  perforations,  through  one  of  which  a  per- 
pendicular glass  tube  passes  down  below  the  surface  of  the 
liquid  contents ;  through  the  other  aperture  a  tube  bent  at 
right  angles  is  inserted,  out  of  which  the  generated  gas 
issues.  A  drying  tube  (containing  fragments  of  fused 
chloride  of  calcium,  or  of  pumice  stone  moistened  with  sul- 
phuric acid)  is  fastened  by  one  end  to  the  exit  tube,  and  by 
the  other  extremity  to  a  horizontal  tube   of  hard   German 


ARSENIC MARSH'S    TEST.  249 

glass,  about  a  foot  long,  which  may  b>2  turned  up  at  the 
farthest  end,  and  made  to  terminate  in  a  small  point,  for 
burning  the  gas  in  a  jet,  as  it  escapes. 

In  performing  this  experiment  certain  precautions  are 
necessary.  In  the  first  place,  the  absolute  purity  of  the 
zinc  and  sulphuric  acid  must  be  secured,  since  both  of  them 
are  liable  to  be  contaminated  with  arsenic.  Secondly,  cau- 
tion should  be  exercised  to  have  the  atmospheric  air  com- 
pletely expelled  from  the  apparatus  before  lighting  the  jet, 
otherwise  the  mixture  of  hydrogen  and  air  will  produce  a 
violent  explosion.  The  evolution  of  the  hydrogen  should 
be  rather  slow  and  gradual.  After  waiting  the  proper  time, 
the  jet  may  be  lighted  ;  it  will  burn,  if  pure,  with  a  scarcely 
perceptible  flame.  The  purity  of  the  materials  may  now  be 
tested  by  applying  the  flame  of  a  large  spirit  lamp,  or  a 
Bunsen  burner,  to  the  horizontal  glass  tube  until  it  is  red 
hot;  if  no  stain  or  deposit  occurs  just  beyond  the  heated 
spot,  the  absence  of  arsenic  is  certain  ;  or,  if  no  deposit 
forms  on  a  piece  of  white  porcelain  held  over  the  burning 
jet,  the  same  conclusion  may  be  held. 

A  small  quantity  of  the  suspected  solution  is  now  to  be 
introduced  through  the  upright  tube;  its  decomposition 
immediately  commences,  freeing  the  arseniureted  hydrogen^ 
which  yields  the  following  characteristic  results  : — 

(i)  The  ignited  jet. — As  soon  as  the  arsenic  combines 
with  the  hydrogen,  an  immediate  change  occurs  in  the 
appearance  of  the  flame,  which  increases  in  size  and  acquires 
a  faint,  bluish  color,  and  unless  the  arsenic  be  in  minute 
quantity,  it  evolves  white  fumes,  and  gives  out  an  alliaceous 
odor.  If  these  fumes  are  received  into  a  short,  wide  glass 
tube,  they  will  condense  into  a  white  powder,  sometimes 
crystalline,  and  may  be  identified  as  arsenious  acid. 

If  the  jet  be  made  to   impinge  on  a  piece   of  glass   or 
12 


H50  TOXICOLOGY. 

white  porcelain,  held  horizontally,  and  just  within  the  flame, 
a  deposit  of  pure  metallic  arsenic,  of  a  brilliant  steel-gray  or 
brownish-gray  color  occurs,  which  may  be  multiplied  to 
any  extent  by  changing  the  position  of  the  porcelain.  In 
order  to  procure  the  finest  deposits,  the  flame  should  be 
steady  and  not  too  large.  Although  these  spots  may  vary 
somewhat  in  color,  they  are  always  brilliant  and  never 
sooty. 

These  deposits  may  be  identified  (i)  by  their  immediate 
solubility  in  hypochlorite  of  sodium:  stains  of  antimony, 
which  they  most  resemble,  are  not  thus  affected.  (2)  When 
touched  with  a  drop  of  sulphide  of  ammonium,  they  do  not 
immediately  disappear  ;  antimony  stains  are  instantly  dis- 
solved. (3)  Both  metals  dissolve  in  hot  nitric  acid,  and  on 
evaporation  yield  white  residues ;  if  now  touched  with  a 
drop  of  strong  solution  of  nitrate  of  silver,  the  arsenic  spot 
assumes  a  brick-red  color,  while  the  antimonial  stain  remains 
unaffected. 

(2)  Decomposition  of  the  gas  by  heat. — On  placing  the 
flame  of  a  large  spirit  lamp,  or  a  Bunsen  burner,  immediately 
below  the  horizontal  tube  (which  should  previously  be  con- 
tracted after  heating  it  in  several  places),  when  it  becomes 
nearly  red  hot,  a  deposit  of  metallic  arsenic  begins  to  form 
just  in  advance  of  the  flame,  which  should  be  held  a  little 
behind  one  of  the  contracted  spaces ;  the  deposit  continues 
to  increase  until  it  may  completely  occupy  the  whole  of  the 
narrow  space,  and  even  advance  beyond  it.  This  constitutes 
the  arsenical  mirror.  It  may  have  the  steel-gray,  brilliant 
appearance  already  described,  or  even  a  coppery  hue,  and  it 
is  highly  characteristic  of  the  presence  of  arsenic.  Several 
such  mirrors  may  thus  be  obtained,  by  moving  the  flame  to 
different  parts  of  the  horizontal  tube,  provided  there  is  a 
sufficient  amount  of  the  poison  to  operate  upon.     The  tube 


ARSENIC — REINSCH'S   TEST.  251 

may  afterwards  be  filed,  so  as  to  separate  the  mirrors,  which 
may  be  retained  for  exhibition  in  court,  as  positive  proof  of 
the  detection  of  the  poison. 

This  mode  of  experimenting  yields  even  more  delicate 
results  than  the  jet;  but  unless  the  quantity  of  arsenic  is 
extremely  small,  it  will  always  be  possible  to  obtain  both  re- 
sults by  Marsh's  process. 

One  fallacy  only  might  interfere  with  this  experiment — 
the  presence  of  antimony,  which  in  contact  with  hydrogen 
yields  a  gas  very  similar  to  arseniureted  hydrogen,  and  like 
the  latter,  is  decomposed  by  heat,  yielding  a  metallic  deposit. 
They  may  be  distinguished  as  follows:  the  antimony  mirror 
is  deposited  just  over  the  heated  spot,  and  not  in  advance 
of  it;  it  has  usually  a  darker  appearance  than  the  arsenical 
mirror;  the  latter  is  more  easily  volatilized  than  the  former, 
and  condenses  higher  up  in  the  tube,  in  octahedral  crystals. 
The  two  deposits  may  also  be  tested  by  the  different  reagents 
mentioned  above  (vid.  p.  246);  also,  by  dry  sulphuretted 
hydrogen,  which  produces  with  the  arsenical  gas  a  yellow 
deposit,  and  with  the  antimonial  gas  an  orange-red. 

(3)  Decomposition  by  nitrate  of  silver. — If  the  arseniureted 
hydrogen  gas  be  passed  through  a  solution  of  nitrate  of 
silver,  it  immediately  blackens  it,  from  the  precipitation  of 
metallic  silver,  arsenious  acid  remaining  in  the  solution. 
The  filtered  clean  solution  will  contain,  also,  free  nitric  acid, 
and  any  excess  of  nitrate  of  silver.  On  neutralizing  with 
ammonia,  a  yellow  precipitate  will  fall — arsenite  of  silver 
(vid.  p.  247).  The  analyst  should  not  rely  on  the  mere 
production  of  the  black  color,  since  other  gases  beside  ar- 
seniureted hydrogen  might  cause  this,  but  he  should  con- 
tinue the  experiment  as  above  described. 

V.  Reinsclis  Test. — This  consists  in  producing  a  deposit 
of  metallic  arsenic  on  bright  copper  foil.     The   suspected 


9S9 


TOXICOLOGY. 


solution,  acidulated  with  about  one-sixth  of  its  bulk  of  pure 
hydrochloric  acid,  is  first  brought  to  the  boiling  point,  and 
a  piece  of  bright  copper  foil  is  introduced,  and  the  boiling 
continued.  The  presence  of  even  a  very  minute  quantity 
of  arsenic  is  soon  indicated  by  the  tarnishing  of  the  copper, 
which  ultimately  assumes  a  dark  steel-gray,  or  even  black, 
color.  If  the  quantity  of  arsenic  be  large,  the  deposit  is 
immediate,  and  very  dark  ;  it  may  even  break  off  in  scales  ; 
if  the  amount  of  the  poison  is  very  small,  the  stain  upon  the 
copper  will  be  fainter,  and  merely  of  a  violet,  or  bluish  tint. 
Moreover,  the  deposit  on  the  copper  is  affected  by  the  de- 
gree of  dilution  ;  hence,  if  the  quantity  of  the  water  be  large, 
it  may  require  boiling  for  half  an  hour  before  a  visible  de- 
posit occurs. 

This  reaction  is  very  delicate  and  extremely  satisfactory. 
One  great  advantage  that  it  possesses  over  the  other  tests 
is,  that  it  may  be  practiced  in  complex  organic  fluids;  hence, 
this  test  is  usually  employed  in  toxicological  research,  as 
the  trial  test. 

Certain  precautions  are,  however,  required  in  employing 
it.  First,  the  purity  of  the  hydrochloric  acid  must  be 
insured;  this  is  easily  accomplished  by  first  boiling  some  of 
the  acid  diluted  with  water,  and  then  introducing  a  slip  of 
the  copper.  If  no  stain  appears  upon  the  latter  after  fifteen 
minutes,  we  may  be  certain  of  the  absence  of  arsenic  or 
antimony  from  the  acid.  Secondly,  the  copper  must  be 
both  bright  and  pure.  Its  brightness  is  effected  by  rubbing 
it  with  emory  paper,  and  it  maybe  regarded  as />  tire  if,  when 
boiled  in  the  acid  arsenical  liquid,  it  is  not  dissolved,  and 
does  not  impart  a  green  color  to  the  liquid.  But,  if  deemed 
necessary  to  further  test  its  purity,  the  process  of  Mr.  Abel 
may  be  adopted :  Add  to  pure  hydrochloric  acid,  diluted 
with  six  parts  of  water,  one  or  two  drops  of  a  weak  solution 


ARSENIC — REINSCH'S    TEST.  2-03 

of  perchloride  of  iron ;  boil  the  acid  liquid,  and  introduce 
into  it  the  copper,  well  polished  ;  if  it  contains  arsenic  it 
soon  becomes  tarnished ;  if  pure  it  remains  bright.  (Taylor, 
Med.Jurisp.,  1883,  p.  268.) 

In  applying  this  test,  it  is  best  to  use  small  pieces  of 
copper  successively,  removing  each  fragment  as  it  becomes 
coated.  By  this  means  the  whole  of  the  arsenic  may  be 
removed  from  the  solution.  We  have  ascertained,  by  actual 
experiment,  that  one  grain  of  arsenious  acid  dissolved  in 
the  acid  solution,  and  treated  by  Reinsch's  process,  will 
impart  a  distinct,  dark,  steel-gray  coating  to  three  hundred 
square  inches  of  copper  surface.  This  method  will,  there- 
fore, serve  for  an  approximative  quantitative  estimate  of  the 
poison. 

Another  caution  to  be  observed  is  not  to  remove  the 
copper  too  soon  from  the  liquid,  in  case  no  deposit  occurs  ; 
in  doubtful  cases,  the  boiling  should  be  continued  for  half 
an  hour.  But,  on  the  other  hand,  if  the  copper  be  kept  in 
for  an  hour  or  longer,  it  may  acquire  a  dark  film,  independ- 
ently of  any  arsenic. 

Fallacies. — Other  metals  beside  arsenic  will  impart  a  dark 
coating  to  copper  by  Reinsch's  process,  such  as  antimony, 
mercury,  silver,  bismuth,  tin,  gold,  platinum  and  palladium, 
and  likewise  organic  matter,  especially  if  it  contain  sulphur. 
Hence,  in  the  application  of  this  test,  the  mere  production 
of  a  dark  deposit  on  the  surface  of  the  copper  is  not 
sufficient  to  establish  the  presence  of  arsenic,  but  further 
corroborative  proof  is  required.  This  is  afforded  by  wash- 
ing a  fragment  or  two  of  the  coated  copper,  and  then 
thoroughly  drying  them  between  the  folds  of  filtering  paper, 
(avoiding  touching  with  soiled  fingers),  and  rolling  them  up 
into  small  coils,  and  then  introducing  one  or  more  of  them 
into  a  small,  clean  reduction-tube  and  applying  the  heat  of 


254  TOXICOLOGY. 

a  spirit  lamp.  The  arsenic  will  volatilize  and  condense  in 
the  cool  part  of  the  tube,  in  a  white  ring  of  octahedral  crys- 
tals. The  only  other  metals  which  could  volatilize  under 
such  circumstances  are  antimony  and  mercury  ;  but  the  sub- 
limate from  antimony  is  either  amorphous,  or  else  in  fine, 
acicular  crystals,  while  the  mercurial  deposit  consists  of 
fine,  spherical  globules  of  the  metal,  easily  recognized  by  a 
magnifier. 

The  attention  of  the  toxicologist  should  especially  be 
directed  to  the  fact,  that  if  copper  be  boiled  for  some  time 
in  an  acid  solution  of  complex  organic  matters,  it  will  be- 
come coated  with  a  decided  dark  stain,  and  will,  moreover, 
yield,  when  heated  in  a  reduction-tube,  an  amorphous 
sublimate,  which  may  even  sometimes  show  acicular  crys- 
tals, consisting  apparently  of  a  compound  of  copper.  YYe 
have  repeatedly  verified  this  by  our  own  observations. 
Hence,  it  follows  that,  for  the  complete  corroboration  of 
Reinsch's  test  for  arsenic,  in  a  medico-legal  case,  we  can 
admit  nothing  short  of  the  production  of  the  octahedral  crys- 
tals, and  their  subsequent  identification. 

It  must  also  be  remembered  that  the  presence  of  certain 
substances  in  the  arsenical  solution  may  prevent  the  deposit 
of  this  metal  upon  the  copper,  viz.,  a  cJdorate,  binoxide  of 
manganese,  or  other  bodies  that  decompose  hydrochloric 
acid  and  evolve  chlorine  ;  likewise  strong  nitric  acid.  Con- 
sequently, Reinsch's  test  is  //^applicable  to  the  clear  solu- 
tion obtained  by  boiling  the  viscera  in  hydrochloric  acid 
and  chlorate  of  potassium  (z>id.  post) 

VI.  Bloxanis  method. — The  principle  here  involved  is  the 
same  as  that  in  Marsh's  process — the  action  of  arsenic  on 
nascent  hydrogen ;  only,  electrolysis  is  employed  to  decom- 
pose the  water  instead  of  zinc.  It  is  a  delicate  and  satis- 
factory method,  but    it    should   be    remembered    that   the 


ARSENIC — TOXICOLOGICAL    EXAMINATION.  255 

arsenic  must  always  be  present  in  the  form  of  arsenious 

acid. 

There  are  some  other  reagents  of  inferior  importance  for 
the  recognition  of  arsenic,  as  lime  water,  iodide  of  potassium, 
bichromate  of  potassium,  etc.,  but  these  require  no  further 
notice. 

Toxicological  examination. — The  analyst  should  always 
first  search  for  particles  of  solid  arsenious  acid  in  the 
stomach  and  the  vomited  matter,  and  carefully  remove 
these  for  examination.  Organic  mixtures  should  be  diluted, 
if  necessary,  with  distilled  water,  and  acidified  with  about 
one-sixth  part  of  hydrochloric  acid  and  boiled  gently  for 
about  fifteen  minutes  ;  when  cooled  the  mixture  should  be 
strained  and  concentrated  by  evaporation  over  a  water  bath. 
A  portion  may  now  be  subjected  to  a  trial  test  by  Reinsch's 
process  ;  if  no  deposit  takes  place  after  boiling  for  half  an 
hour,  it  is  safe  to  conclude  that  no  arsenic  is  present.  But 
if  deemed  advisable,  another  portion  of  the  filtrate  may  be 
subjected  to  Marsh's  process,  and  to  the  action  of  sulphur- 
etted hydrogen. 

The  stomach  and  contents. — This  organ  should  first  be 
carefully  examined  as  to  its  pathological  condition  (vid. 
ante,  p.  61),  and  also  for  the  presence  of  solid  particles  of 
the  poison.  It  should  then  be  cut  up  into  small  fragments, 
with  scissors  known  to  be  perfectly  clean,  and  together  with 
its  contents,  placed  in  a  clean,  porcelain  evaporating  dish, 
distilled  water  added  in  sufficient  quantity,  together  with 
about  one-sixth  the  bulk  of  pure  hydrochloric  acid,  and  the 
whole  boiled  gently  for  about  an  hour,  when  most  of  the 
solid  portions  will  have  become  disintegrated.  After  cool- 
ing, the  mixture  is  thrown  upon  a  muslin  strainer,  and  the 
solid  matters  washed  several  times  with  pure  warm  water 
and  squeezed.     The  strainer  and  contents  should  be  pre- 


2-3<J  TOXICOLOGY. 

served  for  subsequent  examination,  if  required.  The  filtrate 
should  be  concentrated  by  evaporation  over  a  water  bath, 
and  then  filtered  through  paper. 

Reinsch's  process  may  now  be  applied  as  a  trial  test  to  a 
portion  of  the  liquid.  If  no  result  is  afforded  after  a  suffi- 
cient boiling,  other  portions  may  be  tried  by  Marsh's  pro- 
cess, and  by  sulphuretted  hydrogen;  and  if  these  give  nega- 
tive results,  the  absence  of  arsenic  may  be  regarded  as  es- 
tablished. 

But  if  the  presence  of  the  poison  is  revealed  by  the  trial 
test,  a  given  portion  of  the  liquid  may  be  completely  ex- 
hausted by  Reinsch's  process  (vtd.  ante,  p.  251),  and  the 
balance  treated  with  sulphuretted  hydrogen  for  several  hours, 
until  all  the  arsenic  is  precipitated.  This  process  is  facilitated 
by  gently  warming  the  liquid.  The  resulting  precipitate 
will  have  a  dirty  yellowish  color — not  the  bright  yellow 
where  the  arsenic  is  pure, —  and  will  contain  both  organic 
matter  and  reduced  sulphur,  in  greater  or  less  amounts. 

The  mere  production  of  such  a  precipitate  is  not  sufficient, 
of  itself,  to  establish  the  presence  of  arsenic,  since  it  is  know  n 
that  in  an  acid,  complex,  organic  solution,  associated  with 
coloring  matter,  sulphuretted  hydrogen  will  throw  down  a 
precipitate  very  much  resembling  either  an  impure  arsenical 
or  antimonial  sulphide,  but  consisting  only  of  organic  matter 
and  free  sulphur;  hence,  a  further  examination  is  required 
to  verify  this  suspected  sulphide. 

The  precipitate  then  should  be  washed  carefully  on  a  fil- 
ter, and  digested  with  pure  aqua  ammonias,  which  will  dis- 
solve out  all  the  sulphide  of  arsenic,  together  with  some 
organic  matter.  The  solution  is  filtered  and  carefullv 
evaporated  to  dryness.  If  much  arsenic  is  present  it  will 
have  a  decided  yellow  color.  When  perfectly  dried  it 
should  be  verified  by  the  methods  described  above  (p.  248). 


ARSENIC TOXICOLOGICAL    EXAMINATION.  257 

If,  however,  only  a  minute  quantity  of  arsenic  be  present  in 
the  dried  residue,  which  will  have  a  brown  color,  it  must  be 
purified  as  follows:  it  is  placed  in  a  porcelain  capsule,  and 
a  little  concentrated  nitric  acid  is  added,  and  the  mixture 
evaporated  to  dryness  over  a  water  bath,  the  acid  being  re- 
peated until  the  moist  residue  has  a  yellow  color.  It  is  next 
moistened  with  a  few  drops  of  solution  of  caustic  soda,  to- 
gether with  a  little  pure  carbonate  and  nitrate  of  sodium  well 
stirred,  and  cautiously  evaporated  to  dryness.  The  heat  is 
now  gradually  increased  until  the  mass  becomes  colorless, 
when  the  organic  matter  may  be  considered  completely  de- 
stroyed. The  cooled  mass  consists  of  a  mixture  of  the  ar- 
senate of  sodium  with  nitrate  and  nitrite  of  sodium.  It  should 
be  dissolved  in  warm  water,  and  after  filtration,  should  be 
acidulated  with  pure  sulphuric  acid  and  evaporated  till  dense 
white  fumes  appear.  By  this  treatment  the  residue  is  re- 
duced to  a  mixture  of  the  arsenate  and  sulphate  of  sodium. 
A  portion  of  this  solution  may  now  be  tested  in  a  Marsh's 
apparatus;  another  given  portion,  by  sulphuretted  hydrogen, 
for  quantitative  determination,  the  arsenic  acid  being  first 
reduced  to  arsenious  acid  by  sulphurous  acid,  or  sulphite  of 
sodium. 

Separation  of  absorbed  arsenic  from  the  tissues. — It  is 
always  desirable,  if  not  indispensable,  in  a  poison  case,  to 
prove  the  presence  of  absorbed  arsenic  in  the  different 
viscera,  as  the  liver,  kidneys,  spleen,  etc.,  inasmuch  as  its 
detection  in  the  organs  is  positive  proof  that  the  poison  had 
been  actually  taken  during  life,  provided  always  that  post- 
mortem imbibition  can  be  excluded  {vid.  ante,  p.  193).  Be- 
sides, it  may  happen  that,  if  the  quantity  swallowed  has  been 
only  just  sufficient  to  have  caused  death,  the  whole  of  it 
may  have  disappeared  from  the  stomach  by  absorption,  and 
can  only  be  discovered  in  the   organs.     The  brain   should 


258  TOXICOLOGY. 

always  be  examined  ;  in  the  only  case  where  this  organ  was 
submitted  to  an  examination  by  us,  arsenic  was  readily 
discovered  by  the  usual  tests. 

Several  methods  are  described  for  this  sort  of  research, 
all  having  reference  to  one  common  end — the  destruction  of 
organic  matters.  In  several  instances,  we  have  succeeded 
perfectly  in  detecting  arsenic  in  the  organs  by  simply  boil- 
ing the  finely-divided  tissue  in  water  and  hydrochloric  acid, 
and  applying  Reinsch's  test. 

Method  of  Fresenius  and  Babo. — The  solid  matters  (as 
about  one-fourth  of  the  liver)  should  be  finely  divided, 
pressed  in  a  mortar,  and  pure  water  added  to  bring  it  to  the 
consistence  of  thin  gruel.  The  whole  should  then  be 
digested  in  a  porcelain  dish  over  a  water  bath,  with  pure 
hydrochloric  acid  about  equal  in  weight  to  the  dry  material. 
Small  quantities  of  powdered  chlorate  of  potassium  are 
from  time  to  time  added  to  the  hot  liquid,  when  efferves- 
cence will  occur,  with  escape  of  chlorine  gas.  In  a  short 
time  the  solid  matters  will  disappear,  and  the  liquid  will 
acquire  a  clear,  yellow  color.  The  heat  should  be  con- 
tinued until  all  odor  of  chlorine  has  disappeared.  When 
the  liquid  has  cooled,  it  should  be  properly  strained.  Any 
arsenic  present  would  exist  in  the  form  of  arsenic  acid. 

A  portion  of  this  liquid  may  be  tested  in  a  Marsh's  appa- 
ratus (i'id.  p.  248).  But  for  the  other  tests  it  is  necessary 
that  the  arsenic  acid  should  be  reduced  to  the  lower  oxide — 
arsenious  acid.  This  is  effected  by  adding  sulphite  of  sodium 
to  the  solution,  and  heating  it  until  all  odor  of  sulphurous 
acid  has  disappeared.  It  is  now  allowed  to  stand  for  several 
hours,  and  any  deposit  removed  by  filtration.  The  resulting 
solution  may  be  examined  by  sulphuretted  hydrogen,  but 
not  by  Reinsch's  process,  for  the  reason  above  given  {rid. 
V-  254). 


ARSENIC EXAMINATION    OF    THE     URINE.  259 

MetJiod  of  Danger  and  Flandin — The  organs,  properly 
divided,  are  introduced  into  a  glass  retort,  together  with 
strong  sulphuric  acid,  and  heated  on  a  sand-bath,  until  the 
whole  is  thoroughly  carbonized,  and  dried.  After  cooling, 
the  mass  is  removed  and  powdered.  The  powder  is  mois- 
tened in  a  porcelain  capsule,  with  one-tenth  of  its  weight  of 
pure  nitric  acid,  and  heated  on  a  water-bath  for  half  an  hour. 
This  converts  the  arsenic  into  arsenic  acid.  Warm  distilled 
water  is  now  added,  and  the  matters  filtered  through  paper. 
The  filtrate  is  colorless,  if  pure;  if  colored,  it  must  be 
evaporated  to  dryness,  treated  again  with  nitric  acid  and 
water,  and  filtered  the  second  time.  The  acid  liquid  must 
next  be  evaporated  to  dryness,  to  get  rid  of  the  nitrous 
vapors.  It  should  now  be  mixed  with  a  sufficient  quantity 
of  water,  when  it  will  be  fit  for  testing,  as  above  described. 

The  distillation  process. — The  tissue  should  first  be 
thoroughly  dried  over  a  water-bath,  and  then  mixed  with 
about  its  own  weight  of  pure  hydrochloric  acid,  and  dis- 
tilled in  a  retort  over  a  sand-bath,  almost  to  dryness,  the 
distillate  being  received  into  a  small  quantity  of  water 
properly  refrigerated.  By  this  process  the  arsenic  is  sepa- 
rated as  a  ter chloride.  It  possesses  the  advantage  of  imme- 
diately separating  the  arsenic,  in  a  tolerably  pure  state,  from 
the  tissues.  The  distillate  may  be  subjected  to  all  the  usual 
tests. 

The  urine  can  be  examined  by  Reinsch's  test,  by  first 
concentrating  by  evaporation  ;  or  it  may  be  evaporated  to 
dryness,  and  then  treated  with  hydrochloric  acid  and  chlo- 
rate of  potassium,  and  examined  in  the  usual  way. 

Arsenic  is  not  a  normal  constituent  of  the  human  body. 
Neither  is  it  ever  found  in  the  soil  of  cemeteries  in  a  soluble 
state ;  consequently,  there  need  be  no   apprehension  of  a 


260  TOXICOLOGY. 

dead  body  ever  imbibing  this  poison,  after  burial,  from  the 
surrounding  earth. 

Arsenic  is  estimated  quantitatively,  as  a  sulphide ;  ioo 
grains  of  pure  dried  sulphide  represent  80.48  of  arsenious 
acid. 

OTHER    PREPARATIONS    OF    ARSENIC. 

Arsenite  of  Potassium — Fowler  s  Solution. — This  prepara- 
tion, much  used  in  medicine,  is  made  by  boiling  arsenious 
acid  with  carbonate  of  potassium  and  tincture  of  lavender. 
It  contains /#///'  grains  of  arsenic  to  the  fluid  ounce. 

Arsenic  Acid. — A  powerful  poison,  but  not  employed  as 
such.  It  is  tested  as  arsenious  acid;  with  sulphuretted  hy- 
drogen it  yields  a  yellow  precipitate  after  a  considerable 
time.  Its  most  delicate  test  is  nitrate  of  silver,  which  yields 
a  brownish-red  precipitate — arsenate  of  silver. 

The  N.  Y.  Medico-legal  Journal,  March,  1884,  contains  an 
interesting  account,  by  Prof.  B.  Silliman,  of  the  death  of  a 
boy,  aged  between  three  and  four  years,  from  arsenate  of 
sodium,  a  poisonous  preparation  sold  in  New  York,  under 
the  name  of  pest  poison,  for  destroying  potato  bugs.  The 
most  singular  circumstance  connected  with  the  case  is  the 
entire  absence  of  all  the  usual  symptoms  of  arsenic  pois- 
oning, such  as  pain,  vomiting  and  purging,  etc.;  but,  on  the 
contrary,  those  of  a  powerful  narcotic,  like  belladonna, 
or  stramonium.  There  were  profound  stupor,  dilatation  of 
the  pupils,  a  rapid  pulse,  and  hurried  respiration.  After 
partial  recovery,  a  relapse  took  place,  the  child  dying,  ap- 
parently, from  asphyxia,  about  nine  hours  after  swallowing 
the  poison. 

Arsenite  of  Copper — Scheele's  Green. — A  fine  green  powder, 
containing  one  part  of  arsenious  acid  to  two  of  oxide  of 
copper.     By  sublimation  in  a  reduction-tube,  it  yields  crys- 


ARSENIC SULPHIDES.  261 

tals  of  arsenious  acid.     It  is  soluble   in  ammonia  and   in 
nitric  acid. 

Aeeto-arsenite  of  Copper — Selnueinfurt,  or  Brunswick 
Green — Vienna,  or  Emerald  Green — Paris  Green. — A  pig- 
ment very  much  used  for  staining  wall  paper,  bon-bon 
paper,  toys,  etc.  Also,  to  give  a  fine  green  color  to  articles 
of  dress,  artificial  flowers,  and  millinery.  It  is  composed  of 
six  parts  of  arsenious  acid,  two  of  oxide  of  copper,  and  one 
of  acetic  acid.  It  is  readily  identified  by  heating  it  in  a  test 
tube,  when  it  gives  off  fumes  of  acetic  acid,  deposits  crystals 
of  arsenious  acid,  and  leaves  a  residue  of  oxide  of  copper. 

Paper,  and  other  articles  colored  with  this  pigment,  may 
be  easily  tested  by  dipping  them  into  a  weak  solution  of 
ammonia,  when  they  will  be  speedily  bleached,  and  the 
solution  will  become  blue.  If  now  a  crystal  of  nitrate  of 
silver  be  placed  in  the  latter,  a  film  of  yellow  is  immediately 
formed  around  it — arsenite  of  silver.  A  drop  of  aqua 
ammoniae  applied  to  paper  colored  by  this  pigment  imme- 
diately turns  it  blue. 

Chronic  arsenical  poisoning  is  a  frequent  result  of  living 
in  rooms  whose  walls  are  covered  with  this  green  paper  ; 
the  fine  powder  or  dust  detached  from  the  walls  is  inhaled 
into  the  lungs,  and  produces  the  symptoms  above  described. 

Sulphides. — There  are  two  native  sulphides,  the  yellow 
(tersulphide)  or  orpiuie/it,  and  the  red  (pentasulphide)  or 
realgar.  The  yellow  sulphide  is  sometimes  taken  as  a 
poison.  They  are  both  soluble  in  ammonia,  and  when 
mixed  with  a  reducing  agent  and  sublimed,  they  yield 
metallic  mirrors  (vid.  ante,  p.  248). 


262  TOXICOLOGY 


CHAPTER   XVIII. 

POISONING  BY  ANTIMONY— (TARTAR  EMETIC). 

PROPERTIES  OF  TARTAR  EMETIC — SYMPTOMS — FATAL  DOSE — POST- 
MORTEM APPEARANCES — SLOW  POISONING — CHEMICAL  ANALYSIS — 
TOXICOLOGICAL    EXAMINATION. 

The  only  preparation  of  antimony  of  medico-legal  im- 
portance is  tartar  emetic.  Occasionally,  the  chloride  is  a 
cause  of  poisoning. 

Tartar  Emetic  {tartarized  antimony ;  stibiaied  tartar, 
tartrate  of  antimony  and  potassium).  This  is  a  double  salt, 
consisting  of  tartaric  acid  in  combination  with  teroxide  of 
antimony  and  protoxide  of  potassium.  When  pure,  it 
occurs  in  large,  colorless,  octahedral  crystals;  also  as  a  white 
powder.  The  commercial  salt  sometimes  contains  traces  of 
arsenic.  Heated  in  a  reduction-tube,  it  readily  blackens, 
from  the  decomposition  of  the  organic  acid,  and  is  reduced 
to  a  mixture  of  carbon  and  metallic  antimony.  Heated  on 
charcoal,  before  the  blowpipe,  it  is  also  reduced,  yielding 
globules  of  the  metal,  along  with  a  white  incrustation  of  the 
oxide. 

It  is  soluble  in  three  parts  of  boiling,  and  fifteen  of  cold 
water ;  its  solution  soon  undergoes  decomposition.  It  is 
insoluble  in  alcohol.  A  hot  solution  on  evaporation  yields 
tetrahedral  crystals. 

The  taste  is  nauseous,  metallic  and  acrid,  or,  according  to 
some,  slightly  sweetish  and  styptic. 

Symptoms. — A  harsh,  metallic  taste  is  perceived  on  swal- 
lowing, soon  followed  by  nausea,  retching,  violent  and 
incessant  vomiting,  great  thirst,  constriction  of  the  throat, 


ANTIMONY — FATAL    PERIOD.  263 

burning  pain  in  the  stomach  and  abdomen,  profuse  purging 
of  a  watery  character;  sometimes  blood  is  found  in  the  dis- 
charges both  from  the  stomach  and  bowels  ;  severe  cramps 
in  the  extremities,  a  very  feeble,  rapid  pulse,  profuse  per- 
spiration, extreme  prostration,  with  a  disposition  to  syncope. 
The  urine  is  generally  increased  in  quantity,  but  is  voided 
with  pain  ;  at  times  there  may  be  delirium  and  convulsions 
preceding  death.  In  exceptional  cases,  there  is  an  absence 
of  vomiting  and  purging,  the  symptoms  being  those  of  ex- 
treme collapse,  with  a  cold,  clammy  sweat,  feeble  respiration, 
irregular  pulse,  delirium,  unconsciousness  and  tetanic  con- 
vulsions.    (Husemann,  Toxicol,  p.  853.) 

An  occasional  symptom,  if  the  patient  survives  three  or 
four  days,  is  a  pustular  eruption  over  the  body,  similar  to 
that  produced  by  the  external  application  of  tartar  emetic. 

In  some  instances  it  appears  to  exert  a  slightly  corrosive 
impression,  causing  aphthous  ulceration  of  the  tongue  and 
inside  of  the  mouth. 

While  acting  as  an  irritant  to  the  gastro-enteric  mucous 
membrane,  it  undoubtedly  exerts  a  depressant  effect  upon 
the  heart. 

Fatal  dose. — This  has  not  been  precisely  determined.  A 
good  deal  depends  on  the  idiosyncrasy.  In  some  cases, 
two  or  three  grains  have  produced  alarming  and  even  fatal 
effects,  whilst,  in  others,  enormous  doses,  up  to  an  ounce, 
have  failed  to  destroy  life.  Large  doses,  by  exciting  speedy 
vomiting,  generally  relieve  themselves.  Probably,  twenty 
to  forty  grains  may  be  regarded  as  the  usual  minimum 
fatal  dose  for  an  adult. 

Fatal  period. — From  an  hour,  up  to  several  days.  In  an 
exceptional  case  related  by  Deutsch,  a  woman  took  by  mis- 
take a  scruple  of  tartar  emetic,  and  died  one  year  afterwards, 
from  the  irritant  effects  on  the  alimentary  canal. 


2  6  ±  TOXICOLOGY. 

Post-mortem  appearances. — The  irritant  effects  of  this 
poison  are  displayed  upon  the  lining  membrane  of  the 
stomach  and  bowels,  which  is  deeply  reddened,  softened  and 
covered  with  a  blackish,  thick  and  viscid  secretion,  some- 
times streaked  with  blood.  The  throat,  oesophagus,  stomach 
and  bowels  also  exhibit  aphthous-looking  spots,  or  excoria- 
tions, and  occasionally  true  pustules  may  be  seen  scattered 
throughout  the  intestinal  tract. 

The  liver  is  generally  enlarged  and  softened,  and  seems 
to  have  undergone  a  fatty  degeneration.  It  is  stated  that 
the  natives  of  Brunswick  feed  their  geese  upon  the  oxide  of 
antimony,  for  the  purpose  of  fattening  them  by  increasing 
the  size  of  their  livers. 

The  lungs  are  often  deeply  congested,  sometimes  exhibit- 
ing a  true  apoplexy.  The  mucous  lining  of  the  windpipe 
and  bronchi  is  uniformly  reddened.  The  brain  is  generally 
congested,  both  in  its  membranes  and  substance,  the  latter 
presenting,  when  cut,  numerous  bloody  points.  The  ven- 
tricles occasionally  contain  an  excess  of  serum,  and  there 
may  also  be  some  sub-meningeal  serous  effusion.  The 
Jieart  exhibits  nothing  abnormal. 

Treatment. — Vomiting  should  be  assisted  by  warm  muci- 
laginous drinks,  or  the  stomach-pump  may  be  employed. 
The  proper  antidote  is  tannin,  in  the  form  of  some  astringent 
vegetable  infusion,  such  as  green  tea,  or  galls.  Afterward, 
opium  and  stimulants  will  be  necessary. 

Chronic  poisoning. — This  method  of  poisoning  is  believed 
to  be  more  frequent  than  formerly.  The  symptoms  are  a 
distressing  nausea,  with  occasional  vomiting,  diarrhoea,  with 
pasty  stools,  loss  of  appetite,  emaciation,  slimy  tongue,  feeble 
action  of  the  heart,  difficult  breathing,  a  pale  and  anxious 
countenance,  faintings,  with  increased  perspiration  and 
urination. 


A  N  'J'  [MON  Y — TESTS.  2  <  I  •") 

External  application. — When  applied  to  the  skin,  tartar 
emetic  occasions  deeppustulation;  it  is  also  readily  absorbed, 
especially  from  abraded  surfaces,  and  produces  all  its  con- 
stitutional effects  the  same  as  if  swallowed,  such  as  nausea, 
vomiting,  debility,  etc.  Fatal  effects  have  thus  resulted,  and 
the  poison  has  been  detected,  after  death,  in  the  stomach, 
liver,  kidneys,  and  other  organs. 

Chemical  analysis. —  I.  As  a  solid. — Touched  with  a  drop 
of  sulphide  of  ammonium,  or  a  solution  of  sulphuretted 
hydrogen,  it  immediately  acquires  an  orange-red  color ;  this 
is  characteristic  of  all  the  salts  of  antimony  in  their  pure 
state.     Heated  in  a  reduction-tube,  it  blackens  {rid.  p.  262). 

2.  As  a  liquid. — (a)  A  drop  of  a  strong  solution,  evapo- 
rated on  glass,  will  exhibit  the  tetrahedral  crystals  ;  a  weak- 
solution  gives  a  mass  of  confused  crystals.  (/;)  Either  of 
the  mineral  acids  dropped  into  it  produces  a  white  precipi- 
tate, soluble  in  an  excess  of  the  acid;  this  precipitate  is  also 
soluble  in  tartaric  acid,  (c)  No  precipitate  by  ferrocyanide 
of  potassium,  (d)  Acidulated  with  hydrochloric  acid,  and 
boiled  on  bright  copper  foil,  the  latter  acquires  a  violet- 
colored  deposit  of  metallic  antimony  (Reinsch's  test). 
(e)  The  above  solution  imparts  a  black  stain  to  a  strip  of 
pure  tin  foil  in  the  cold,  whereby  it  is  distinguished  from 
arsenic.  (/)  Sulphuretted  hydrogen,  or  sulphide  of  ammo- 
nium, throws  down  from  a  pure  solution  a  characteristic 
orange-red  precipitate  of  sulphide  of  antimony.  This  pre- 
cipitate is  soluble  in  caustic  alkalies,  but  scarcely  so  in 
ammonia ;  insoluble  in  dilute  hydrochloric  acid,  but  if 
boiled  in  the  concentrated  acid,  it  is  decomposed  with  the 
escape  of  sulphuretted  hydrogen,  and  the  formation  of  the 
terchloride  of  antimony.  The  resulting  solution,  if  not  too 
acid,  when  dropped  into  water  immediately  throws  down  a 
copious,  white,  flaky  precipitate  (the  oxychloride,  or  powder 


266  TOXICOL*  ".Y. 

of  algaroth),  which  is  quite  characteristic.  This  may  be 
identified  as  antimonial  (i)  by  its  solubility  in  tartaric  acid; 
(2)  by  touching  it  with  sulphide  of  ammonium,  which  im- 
parts to  it  an  orange-red  color.  The  white  precipitate 
obtained  by  dropping  the  nitrate  of  bismuth  into  water  is 
not  soluble  in  tartaric  acid,  and  is  blackened  by  sulphide  of 
ammonium. 

(g)  The  Galvanic  test. — This  is  made  by  placing  a  few 
drops  of  the  solution,  acidified  by  hydrochloric  acid,  upon  a 
platinum  capsule,  and  touching  the  latter,  through  the  liquid, 
with  a  strip  of  bright  zinc ;  metallic  antimony  is  deposited 
on  the  platinum  at  the  point  of  contact,  as  a  brownish  or 
black  film.  The  liquid  should  then  be  poured  off,  and  the 
platinum  washed  in  distilled  water.  A  small  quantity  of 
sulphide  of  ammonium  poured  upon  the  stain  speedily  dis- 
solves it  (if  antimony)  by  the  aid  of  heat,  and  on  evaporation, 
an  orange-red  sulphide  remains.  A  modification  of  this  test 
may  be  advantageously  applied  for  the  detection  of  antimony 
in  the  organs  {vid.  post) 

(h)  Marsh's  test. — This  is  employed  in  the  same  manner 
as  for  arsenic  {vid.  ante,  p.  248).  If  a  solution  of  tartar 
emetic,  or  any  of  the  soluble  antimonial  salts,  be  subjected 
to  Marsh's  test,  antimo netted  hydrogen  is  generated  in  pre- 
cisely the  same  manner  as  is  arseniureted  hydrogen,  under 
the  same  conditions. 

(1)  If  the  gas  is  inflamed  at  the  jet,  it  burns  with  a  bluish 
flame,  evolving  white  fumes  of  teroxide  of  antimony,  and  if 
these  fumes  are  received  into  a  short,  wide  test-tube,  held 
just  above  the  flame,  the  white  deposit  of  the  teroxide  may 
be  collected,  which  may  be  identified  by  sulphide  of  am- 
monium. If  a  piece  of  cold  white  porcelain  be  held  hori- 
zontally just  within  the  flame,  the  metal  is  deposited  (as  in 
the  case  of  arsenic)  in  the  form  of  a  black,  or  nearly  black, 


ANTIMONY MARSH'S    TEST.  267 

spot,  which  is  usually  surrounded  by  a  grayish  ring.  These 
deposits  may  be  multiplied  by  simply  changing  the  position 
of  the  porcelain. 

The  only  fallacy  to  which  this  test  is  liable  is  from  arsenic, 
which,  as  has  been  shown,  behaves  in  a  precisely  similar 
manner.  But  they  can  readily  be  distinguished  from  one 
another  by  a  little  attention.  The  antimonial  deposit  is,  as 
a  rule,  blacker  and  less  brilliant  than  the  arsenical;  but  if 
the  spots  of  antimony  are  extremely  small — as  when  the 
quantity  examined  is  minute — this  distinction  is  not  so  ob- 
servable. Again,  the  antimony  stains  are  more  slowly  dis- 
sipated by  heat  than  the  arsenical;  the  former  immediately 
dissolve  in  a  drop  of  sulphide  of  ammonium,  leaving,  on 
evaporation,  an  orange-red  deposit;  the  latter  (arsenical)  are 
slowly  affected  by  it,  and  leave,  on  evaporation,  a  yellow 
residue.  Furthermore,  the  arsenic  deposit  is  immediately 
soluble  in  a  solution  of  hypochlorite  of  sodium,  which  has 
little,  or  no  effect  upon  the  antimonial  stain.  Nitric  acid 
will  also  serve  to  distinguish  them:  both  are  dissolved  by 
it,  but  on  evaporation  to  dryness,  the  arsenical  residue 
gives  to  a  solution  of  nitrate  of  silver  a  brick-red  color 
(arsenate  of  silver),  but  the  antimonial  residue  is  not 
affected  by  it. 

(2)  If  heat  be  applied  to  the  horizontal  tube  in  Marsh's 
apparatus  during  the  passage  of  the  antimonctted  hydrogen, 
decomposition  takes  place,  as  in  the  case  of  arsenic,  but  the 
deposition  of  the  antimonial  mirror  occurs  immediately  over 
and  around  the  heated  portion,  and  not  in  advance  of  it. 
If  the  quantity  operated  upon  is  very  small,  the  deposit  may 
take  place  wholly  within  the  point  of  heat.  These  metallic 
deposits  exhibit  the  same  chemical  reactions  as  those  pro- 
duced on  porcelain  by  the  ignited  gas. 

(3)  If  the  antimonctted  hydrogen  be  passed  into  a  solu- 


2G8  TOXICOLOGY. 

tion  of  nitrate  of  silver,  the  latter  (as  in  the  case  of  arsenic) 
becomes  black  ;  the  whole  of  the  antimony  is  precipitated 
as  antimonide  of  silver  (with  arsenic,  the  precipitate  consists 
of  metallic  silver,  the  arsenious  acid  being  kept  in  solution). 
This  black  precipitate  should  be  collected  on  a  filter, 
washed  and  boiled  with  tartaric  acid,  which  dissolves  out 
the  antimony,  and  leaves  the  silver.  On  filtering  the  solu- 
tion, and  treating  it  with  sulphuretted  hydrogen,  the  charac- 
teristic orange-red  sulphide  is  precipitated. 

Toxicological  examination. — In  certain  cases  it  might  be 
desirable  to  separate  the  tartar  emetic,  as  such,  from  the 
stomach  ;  this  may  sometimes  be  accomplished  by  dialysis. 
The  exhibition  of  the  poison  in  the  exact  state  in  which  it 
had  been  szvallozucd,  would  always  strongly  impress  a  jury. 
But  for  all  practical  purposes,  it  is  deemed  sufficient  if  the 
analyst  can  detect  the  antimony.  The  process  of  dialysis 
may  also  be  employed  to  separate  tartar  emetic  from  food 
and  vomited  matters,  but  not,  of  course,  for  detecting 
absorbed  antimony  in  the  tissues. 

The  stomach,  properly  divided,  and  contents,  should  be 
acidulated  with  tartaric  acid  and  gently  heated,  with 
sufficient  distilled  water,  over  a  water  bath,  for  about  half 
an  hour.  When  cold,  the  matters  should  be  strained 
through  muslin ;  the  solid  portions  are  to  be  washed  and 
pressed,  and  the  whole  of  the  liquid  carefully  evaporated  to 
about  one-half.  Trial  tests  may  now  be  made  on  a  portion 
of  this  liquid  (a)  by  inserting  a  piece  of  pure  tin  foil  in  the 
cold;  it  will  soon  blacken  if  antimony  is  present;  (b)  acidu- 
late with  hydrochloric  acid  and  boil  ;  then  place  a  piece  of 
bright  copper  foil  (Reinsch's  test),  it  will  speedily  acquire  a 
violet  stain,  (c)  The  remainder  of  the  liquid,  slightly 
warmed,  should  be  treated  with  sulphuretted  hydrogen  gas 
for  several  hours ;  a  dirty,  orange-red   or  brown  precipitate 


ANTIMONY TOXICOLOGICAL    EXAMINATION.  269 

will  be  thrown  down,  consisting  of  tersulphide  of  antimony, 
organic  matter  and  reduced  sulphur  (vid.  ante,  p.  256). 

The  importance  of  identifying  this  precipitate  cannot  be 
over-estimated  by  the  toxicologist.  The  mere  production  of 
a  reddish-brown  deposit  under  these  circumstances  is  not 
sufficient  to  establish  the  presence  of  the  alleged  poison ; 
what  has  been  said  upon  this  point  under  the  head  of  Ar- 
senic applies  with  equal  force  to  antimony.  Neither  will  it 
suffice  to  proceed  only  one  step  farther,  and  dissolve  the 
suspected  sulphide  in  boiling  hydrochloric  acid,  and  throw 
the  resulting  solution  into  water,  and  obtain  a  white  pre- 
cipitate therein,  since  all  these  results  may  ensue,  as  our 
experience  can  testify,  from  a  similar  treatment  of  the  col- 
ored sulphur-organic  deposits  above  alluded  to,  where  no 
antimony  has  been  present;  for  these  also  are,  to  a  great 
extent,  soluble  in  hot  hydrochloric  acid,  and  the  resulting 
solution,  if  thrown  into  water,  will  occasion  a  white  pre- 
cipitate. We  do  not  wish  to  be  understood  as  saying  that 
these  sulphur-organic  precipitates  possess  all  the  characters 
of  the  true  sulphide  of  antimony — especially  such  as  would 
result  from  a  pure  solution, — but  they  do  resemble  in  many 
respects  the  precipitate  from  an  antimonial  solution  mixed 
with  organic  matters.  It  is  for  this  reason  that  we  insist,  in 
a  poison  case,  on  a  very  searching  corroboration  of  this 
particular  test.  The  analyst  should  proceed  still  another 
step,  and  subject  the  white  precipitate  to  the  action  of  tar- 
taric acid,  and  of  sulphide  of  ammonium  {vid.  p.  266). 

It  may  properly  be  remarked  here  that  in  every  medico- 
legal case  of  poisoning  with  antimony  (as  indeed  with  other 
metals),  the  actual  obtaining  of  the  metal  should  be  rigor- 
ously insisted  on,  as  the  only  absolute  and  unequivocal 
proof;  and  this,  too,  in  quantities  sufficient  to  admit  of  its 
positive  identification  by  all  the  recognized  tests.    Nor  should 


270  TOXICOLOGY. 

this  be  considered  as  a  mere  arbitrary  or  capricious  rule. 
The  highest  toxicological  authorities,  such  as  Orfila,  Tardieu 
and  Taylor,  sanction  it.  Besides,  the  extraction  of  the 
metal  is  not  difficult,  e.  g.,  by  tin  foil,  by  galvanism,  by 
Marsh's  and  Reinsch's  processes,  and  by  the  blowpipe. 

In  the  organs  and  tissues. — Most  of  the  absorbed  poison 
will  be  found  in  the  liver  and  kidneys.  A  given  portion  of 
these  organs,  properly  divided,  should  be  boiled  in  water 
acidulated  with  about  one-sixth  of  hydrochloric  acid.  After 
proper  concentration,  trial  tests  may  be  made  with  a  strip  of 
tin  foil  in  the  cold,  and  copper  foil  in  the  boiling  solution. 
If  any  indications  of  antimony  are  given,  Reinsch's  process 
maybe  carried  out  by  subjecting  a  number  of  pieces  of  cop- 
per to  the  boiling  acid  liquid.  These  should  be  thoroughly 
washed,  and  dried  between  the  folds  of  bibulous  paper;  then 
rolled  up,  and  introduced  into  glass  reduction-tubes,  and 
heated  by  the  flame  of  a  spirit  lamp;  a  white  sublimate  will 
be  deposited  on  the  cool  portion  of  the  tube,  as  in  the  case  of 
arsenic;  but  it  is  either  amorphous,  or  else  composed  of  very 
fine  acicular  crystals  [Millers  Inorganic  Chem.  p.  602). 

The  true  nature  of  this  antimonial  deposit  is  best  shown, 
according  to  Watson,  by  boiling  the  coated  copper  in  a 
dilute  solution  of  caustic  potassa,  the  metal  being  occasion- 
ally withdrawn  from  the  liquid  and  exposed  to  the  air  to 
favor  the  oxidation  of  the  antimony,  when,  after  a  time,  the 
deposit  will  be  wholly  converted  into  antimonate  of  potas- 
sium, which  will  be  in  solution.  The  copper  strip  should 
now  be  removed ;  acidulate  with  hydrochloric  acid,  and 
pass  sulphuretted  hydrogen  through  the  liquid,  when  the 
pcntasulpJiide  of  antimony  will  be  thrown  down,  of  an 
orange-red  color.  The  whole  of  the  antimony  may  be  thus 
removed  by  employing  successive  slips  of  copper,  and  sub- 
jecting them  to  the  above  treatment. 


ANTIMONY — EXAMINATION    OF    THE  URINE.  271 

The  galvanic  test  may  also  be  applied  with  great  certainty, 
to  detect  the  presence  of  antimony  in  the  tissues.  Prof. 
Taylor's  plan  is  an  excellent  one:  Coil  a  portion  of  pure 
zinc  foil  around  a  piece  of  clean  platinum  foil,  and  suspend 
them  in  the  acid  solution  of  the  tissues,  sufficiently  dilute  to 
prevent  too  violent  an  action  on  the  zinc.  The  liquid  should 
be  warmed.  Sooner  or  later,  according  to  the  quantity  of 
antimony  present,  the  platinum  will  be  coated  with  an 
adhering  black  powder  of  metallic  antimony.  Wash  the 
platinum  foil,  and  digest  it  in  strong  nitric  acid,  which  will 
dissolve  off  the  antimony;  remove  the  platinum,  and  evapo- 
rate to  dryness.  Re-dissolve  the  residue  in  hydrochloric 
acid ;  dilute  the  solution,  and  treat  with  sulphuretted 
hydrogen,  which  will  precipitate  the  pure  sulphide  ;  or,  the 
deposit  on  the  platinum  may  be  dissolved  off  by  sulphide 
of  ammonium  (vid.  p.  266). 

The  absorbed  antimony  may  also  be  extracted  by  means 
of  chlorate  of  potassium  and  hydrochloric  acid  {vid.  p.  258). 
But,  in  this  case,  in  the  subsequent  application  of  sulphur- 
etted hydrogen,  there  is  no  occasion  to  employ  sulphurous 
acid  to  effect  a  reduction  to  a  lower  oxide,  as  in  the  case  of 
arsenic. 

It  has  been  ascertained  that  antimony  may  be  eliminated 
through  the  glands  of  the  stomach,  even  when  introduced 
into  the  system  by  some  other  avenue,  e.  g.y  by  antimonetted 
hydrogen  through  the  lungs. 

The  urine  should  always  be  examined  in  cases  of  sus- 
pected antimonial  poisoning.  This  secretion  is  very  soon 
affected  by  the  salts  of  antimony,  and  it  may  contain  traces 
of  them  for  some  time  after  their  discontinuance.  The 
urine  should  be  evaporated  nearly  to  dryness,  when  it  may 
be  examined  either  by  Reinsch's  test,  by  tin  foil,  by  the 
galvanic  test,  by  Marsh's  process,  by  chlorate  of  potassium 


272  TOXICOLOGY. 

and  hydrochloric  acid,  with  sulphuretted  hydrogen,  and  by 
carbonizing  with  sulphuric  acid  [vid.  post.,  p.  259). 

Chloride  of  Antimony  {Butter  of  Antimony). — A  strong, 
corrosive  poison,  and  one  that  has  proved  fatal  in  a  number 
of  instances.  Its  symptoms  and  post-mortem  lesions  re- 
semble those  of  the  corrosive  acids  rather  than  those  pro- 
duced by  tartar  emetic.  When  thrown  into  water,  the  oxy- 
chloride  is  generated,  and  falls  as  a  copious,  white,  flaky 
precipitate.  This  is  soluble  in  tartaric  acid,  and  is  instantly 
colored  orange-red  when  touched  with  sulphide  of  ammo- 
nium. The  clear  liquid  contains  hydrochloric  acid,  as  shown 
by  nitrate  of  silver,  which  precipitates  chloride  of  silver. 

Antimony  is  estimated  quantitatively  as  a  tersulpliide. 
Every  100  grains  of  pure,  dry  tersulphide  are  equivalent  to 
85.75  of  the  teroxide,  or  202.85  parts  of  crystallized  tartar 
emetic. 


POISONING    BY    MERCURY.  273 


CHAPTER  XIX. 

POISONING  BY  MERCURY— (CORROSIVE  SUBLIMATE). 

CORROSIVE  SUBLIMATE. —  PROPERTIES. —  SYMPTOMS. —  POST-MORTEM 
APPEARANCES. — FATAL  DOSE. — ANTIDOTES. — CHEMICAL  ANALYSIS. 
— TOXICOLOGICAL   EXAMINATION. — SALIVATION. 

Mercury  is  not  poisonous  in  the  metallic  state.  Liquid 
mercury  was  formerly  administered  to  relieve  constipation. 
The  vapor  is  poisonous  when  inhaled,  and  as  this  is  given 
off  from  the  metal,  even  at  ordinary  temperatures,  it  happens 
that  artisans  who  work  in  mercurial  ores,  looking-glass  platers, 
water  gilders,  barometer  makers,  etc.,  are  very  liable  to  be- 
come poisoned  by  the  fumes.  The  symptoms  of  this  sort 
of  poisoning  may  come  on  gradually,  or  suddenly;  they  may 
or  may  not  be  accompanied  with  salivation.  They  are 
chiefly  marked  by  the  production  of  tremors  of  the  limbs 
and  paralysis,  indicating  the  action  of  the  metal  on  the  nerve 
centres.  The  general  condition  thus  induced  is  named 
mercurial  tremors,  and  shaking  palsy.  The  upper  extremities 
are  usually  first  affected,  and  then,  by  degrees,  all  the  mus- 
cles of  the  body.  There  is  an  unsteadiness  in  the  arms  and 
legs,  so  that  the  patient  cannot  grasp  an  object,  nor  walk 
firmly  on  the  ground.  In  bad  cases,  he  can  neither  speak, 
nor  chew  his  food.  If  the  disorder  be  not  checked,  it  pro- 
ceeds to  a  fatal  termination,  attended  with  a  loss  of  memory, 
insomnia  and  delirium.  Another  curious  symptom,  not 
generally  recognized,  but  usually  present,  is  a  brittle  state 
of  the  teeth,  causing  them  to  chip  {Guy's  Foren.  Med) 

The  proper  prophylactic  treatment  in  this  affection  con- 
sists in  cleanliness  and  good  ventilation,  together  with  the 
*3 


274  TOXICOLOGY. 

free  internal  use  of  albumen,  in  the  form  of  white  of 
eggs. 

All  the  mercurial  compounds  are  more  or  less  poisonous, 
but  the  most  important  one,  from  a  medico- legal  point  of 
view,  is  corrosive  sublimate. 

Corrosive  Sublimate —  (Mercuric  Chloride —  Corrosive 
Chloride  of  Mercury). — Occurs  either  in  heavy  crystalline 
masses  of  prismatic  crystals,  or  as  a  white  powder.  It  has 
a  powerful  metallic,  styptic,  nauseous  taste,  and  is  soluble 
in  about  sixteen  parts  of  cold,  and  three  of  boiling  water. 
Alcohol  and  ether,  also,  freely  dissolve  it,  and  the  latter  has 
the  power  of  abstracting  it  from  its  aqueous  solution. 

Symptoms. — These  usually  come  on  immediately  after 
taking  the  poison.  A  strong  metallic,  styptic  taste  is  per- 
ceived, with  a  sense  of  heat,  and  choking  in  the  throat.  A 
fierce,  burning  pain  is  felt,  extending  from  the  mouth  to  the 
stomach ;  nausea,  retching  and  vomiting  of  stringy  mucus, 
often  tinged  with  blood  ;  pain  in  the  abdomen,  which  usually 
is  swollen  and  tender  to  the  touch  ;  severe  purging,  some- 
times of  bloody  matters,  accompanied  with  tenesmus,  as  in 
dysentery.  The  pulse  is  feeble,  quick  and  irregular;  coun- 
tenance flushed  and  swollen,  though  sometimes  it  is  pale 
and  anxious;  the  tongue  is  white  and  shriveled;  skin  cold 
and  clammy;  respiration  difficult;  intense  thirst;  urine 
scanty  or  suppressed ;  cramps  of  the  extremities ;  stupor, 
fainting,  convulsions  and  death.  Salivation  is  apt  to  appear 
on  the  second  or  third  day,  but  it  is  not  an  invariable  symp- 
tom in  acute  cases. 

In  some  exceptional  instances  there  has  been  an  absence 
of  abdominal  pain,  as  also  of  vomiting  and  purging. 

Poisoning  from  corrosive  sublimate  differs  from  arsenical 
poisoning:  (i)  the  former  poison  has  a  very  distinct  acrid 
taste,  whilst  the  latter  is  almost  tasteless.     (2)  The  symp- 


CORROSIVE    SUBLIMATE TREATMENT.  275 

toms  of  the  former  come  on  almost  immediately  after  it  is 
swallowed;  those  produced  by  the  latter  are  generally  post- 
poned for  half  an  hour  to  an  hour.  (3)  The  discharges  from 
corrosive  sublimate  poisoning  are  more  frequently  bloody 
than  those  from  arsenic. 

The  external  application  of  corrosive  sublimate  has  often 
been  attended  with  fatal  consequences,  and  both  the  symp- 
toms and  post-mortem  lesions,  in  such  cases,  resemble 
those  produced  by  swallowing  the  poison,  such  as  vomit- 
ing, purging,  suppression  of  urine,  salivation,  etc.,  injection 
of  the  stomach  and  kidneys,  with  ecchymoses  throughout 
the  intestines  and  bladder.  Cases  of  this  character,  result- 
ing fatally,  are  reported,  where  a  solution  of  corrosive 
sublimate  was  applied  to  the  scalps  of  children,  for  the  cure 
of  porrigo  and  ringworm. 

Fatal  dose. — The  minimum  fatal  dose  for  an  adult  may  be 
considered  to  be  three  grains,  although,  as  in  the  case  of 
other  mineral  poisons,  very  large  quantities  have  been  taken 
with  impunity,  having  been  speedily  vomited,  or  promptly 
neutralized  by  proper  antidotes. 

Fatal  period. — Dr.  Taylor  reports  the  shortest  period  on 
record,  where  death  occurred  in  half  an  hour  from  an 
unknown  amount  of  the  poison.  In  the  majority  of  cases 
life  is  prolonged  for  several  days — from  one  to  five.  In  a 
summary  of  cases  given  by  Prof.  Guy  {For en.  Med.  1868, 
p.  475),  about  half  the  number  died  in  less  than  twelve 
hours,  and  the  remaining  half  in  a  period  varying  from 
three  to  eleven  days.  More  than  one-half  the  cases  termi- 
nate fatally. 

Treatment. — Promote  vomiting  by  the  free  use  of  warm 
diluent  drinks.  The  proper  antidote  is  albumen,  as  found 
in  eggs.  This  decomposes  the  mercurial  salt,  forming  an 
insoluble  albuminate;  a  large  excess  of  albumen  will   re- 


276  TOXICOLOGY. 

dissolve  the  precipitate.  The  white  of  one  egg  is  supposed 
to  be  capable  of  neutralizing /<wr  grains  of  corrosive  subli- 
mate. In  the  absence  of  eggs,  gluten  or  wheat  flour,  in  the 
form  of  paste,  may  be  freely  exhibited.  Milk  may  also  be 
freely  used. 

Post-mortem  appearances. — These  are  generally  confined, 
as  in  the  case  of  arsenic,  to  the  mucous  membrane  of  the 
stomach  and  bowels,  but  the  corrosive  action  of  the  mercu- 
rial is  more  marked.  The  stomach,  together  with  the 
mouth,  throat  and  oesophagus,  is  often  softened,  of  a  white 
or  grayish  color,  and  corroded.  The  slate-gray  color  is 
ascribed  to  the  reduction  of  metallic  mercury  upon  the 
lining  membrane.  The  intestines,  especially  the  caecum, 
often  exhibit  similar  appearances.  Perforation  of  the 
stomach  is  rare.  The  kidneys  and  bladder  are  usually 
highly  inflamed,  the  former  especially  congested  about  the 
Malpighian  bodies,  and  the  epithelial  cells  deformed,  gran- 
ular, and  partially  destroyed.  The  bladder  is  empty  and 
contracted. 

According  to  Dr.  Byasson  (Woodman  and  Tidy,  Med. 
Jurisp.  p.  204),  corrosive  sublimate  takes  two  hours  to  reach 
the  urine,  and  four  hours  to  reach  the  saliva.  He  never 
found  it  in  the  perspiration.  He  considers  it  to  be  com- 
pletely eliminated  in  twenty-four  hours  after  it  has  been 
taken. 

In  chronic  or  slow  mercurial  poisoning,  the  symptoms 
generally  presented  are  loss  of  appetite,  metallic  taste  in  the 
mouth,  fetid  breath,  soreness  of  the  gums,  increase  of 
salivary  secretion,  pain  in  the  stomach  and  abdomen,  with 
diarrhoea,  quick  pulse,  hot  skin,  weakness  and  emaciation. 
A  bluish  line  has  been  noticed  at  the  edge  of  the  gums,  as 
in  lead  poisoning. 

Salivation,  although  often  absent  in  acute  mercurial  poi- 


NON-MERCURIAL   SALIVATION.  Z  i  ( 

soning,  is  nearly  always  observed  in  the  chronic  form.  But 
as  this  symptom  accompanies  the  use  of  many  other  drugs, 
it  cannot,  of  itself \  be  regarded  as  a  proof  of  the  administra- 
tion of  mercury.  In  a  doubtful  case,  however,  the  matter 
may  always  be  decided  by  a  chemical  examination  of  the 
saliva  for  mercury  {vid.  infra).  Doubtless,  other  mineral 
poisons  are  eliminated  by  this  secretion,  and  their  presence 
might  be  detected  in  it,  with  proper  attention. 

The  relationship  between  salivation  and  mercurial  poison- 
ing is  a  subject  of  considerable  medico-legal  importance, 
since  charges  of  malpraxis  have  often  been  made  against 
physicians  in  cases  of  profuse  and  fatal  salivation,  accom- 
panied by  necrosis  and  gangrene,  where,  in  some  instances, 
no  mercury  whatever  had  been  administered,  and  in  others, 
where  the  dose  has  been  exceedingly  small.  It  is  well 
known  that  there  is  no  fixed,  definite  period  when  the  sali- 
vation comes  on ;  rarely  before  two  days,  often  later.  A 
case  reported  by  Dr.  Wood  {Ed.  Med.  and  Surg.  Jour.,  vol. 
LI,  p.  141),  in  which  a  teaspoonful  of  corrosive  sublimate 
had  been  swallowed,  salivation  was  profuse  in  the  course  of 
a  few  hours.  It  has  been  suggested  that  this  very  early 
flow  of  saliva  was  probably  due  rather  to  the  local  irritant 
action  of  the  poison,  than  to  the  result  of  absorption. 

An  important  fact,  not  to  be  lost  sight  of,  in  this  relation 
is  that  salivation  may  be  produced  by  various  other  agents 
besides  mercurials,  such  as  iodide  of  potassium,  iodine,  the 
preparations  of  copper,  lead,  bismuth,  arsenic,  antimony, 
digitalis,  croton  oil,  cantharides,  colchicum  and  other  drugs. 
A  case  was  recently  mentioned  to  the  author  where  a  pa- 
tient was  profusely  salivated  by  a  single  dose  of  five  grains 
of  iodide  of  potassium.  It  is  true  that  in  the  majority  of 
the  instances  of  non-mercurial  salivation,  there  is  an  absence 
of  the  usual  mercurial  fetor  of  the  breath  and  the  coppery 


2  t  8  TOXICOLOGY. 

taste,  but  it  would  appear,  from  some  recorded  cases,  that 
these  symptoms  have  been  equally  noticed  in  the  salivation 
produced  by  arsenic  and  bismuth. 

Another  point  of  consideration  for  the  legal  physician  is 
the  great  difference  in  the  susceptibility  of  persons  to  the 
mercurial  impression.  Thus,  it  is  almost  impossible  to 
salivate  a  very  young,  healthy,  child.  Certain  morbid  con- 
ditions of  the  system,  however,  seem  to  predispose  to  its 
action,  as  anaemia  and  albuminuria.  We  have  known  a  dose 
of  compound  cathartic  pills  (containing  only  three  grains 
of  calomel)  to  produce  very  severe  ptyalism.  Dr.  Chris- 
tison  states  that  three  five-grain  doses  of  blue  pill,  one  every 
night,  proved  fatal;  and  that  two  grains  of  calomel  have 
caused  ulceration  of  the  throat,  exfoliation  of  the  jaw,  and 
death. 

Mercurial  salivation  may  be  intermittent,  ceasing  for  a 
time,  and  reappearing  without  the  further  exhibition  of  the 
medicine  during  the  interval. 

Furthermore,  salivation  may  arise  spontaneously,  from 
mechanical  irritation  of  the  mouth,  or  as  the  result  of 
exhausting  diseases,  especially  among  the  children  of  pov- 
erty and  squalor,  who  are  surrounded  by  bad  hygienic 
influences.  Among  the  last-named  subjects,  the  two  dis- 
eases of  cancrum  oris  and  of  gangrene  of  the  mouth  are  of 
frequent  occurrence.  The  symptoms  of  these  conditions 
strongly  resemble  a  very  severe  case  of  mercurial  ptyalism, 
so  that  the  diagnosis  may  be  difficult.  If,  in  such  a  case, 
the  physician  should  have  happened  to  have  administered, 
at  the  beginning  of  the  sickness,  even  a  small  dose  of 
calomel,  it  might  easily  become  a  serious  question  to  deter- 
mine whether  the  death  actually  resulted  from  the  mercury 
acting  as  a  poison,  or  from  the  disease ;  and  it  would  be  no 
difficult  matter  to  get  up  an  action  against  the  medical  man 


CORROSIVE   SUBLIMATE — ANALYSIS.  279 

for  alleged  malpraxis.  Dr.  Taylor  cites  a  case  in  point 
[On  Poisons,  p.  406).  A  charge  was  made  against  a  medical 
practitioner  for  having  caused  the  death  of  a  child,  aged 
four  years,  by  administering  an  overdose  of  some  mercurial 
preparation,  for  the  treatment  of  whooping  cough.  On  the 
fourth  day  the  child  complained  of  soreness  of  the  mouth ; 
the  teeth  became  loose  and  fell  out ;  the  tongue  and  cheek 
were  much  swollen,  and  the  child  died,  in  the  course  of  a 
few  days,  from  gangrene  of  the  left  cheek.  The  answer  to 
the  charge  was,  that  not  a  particle  of  mercury  had  been 
given — a  fact  clearly  proved  from  the  prescription-book  of 
the  medical  attendant.  This  was  clearly  an  instance  in  which 
gangrene  from  spontaneous  causes  had  been  mistaken  for 
mercurial  poisoning.  As  before  observed,  the  chemical 
analysis  of  the  saliva  would  settle  any  question  of  this 
kind. 

Chemical  analysis. — (1 .)  As  a  solid. — (a)  A  fragment  heated 
on  platinum  foil  is  entirely  dissipated  in  white,  acrid  fumes, 
which  condense  on  a  cool  surface  in  white,  radiating  crys- 
tals, (b)  Touched  with  a  drop  of  liquor  potassae,  it  turns  a 
yellowish  color;  calomel,  under  similar  circumstances,  be- 
comes black.  (<f)  A  solution  of  iodide  of  potassium  imparts 
a  bright  scarlet  color;  this  is  a  very  delicate  test.  A  drop 
of  this  latter  solution  placed  upon  a  piece  of  bright  copper, 
in  contact  with  the  smallest  fragment  of  corrosive  sublimate, 
will  produce  a  bright,  silvery  stain  upon  the  copper, 
especially  if  it  be  rubbed  with  the  finger;  this  stain  is  imme- 
diately removed  by  heating  it.  (d)  Sulphide  of  ammonium 
at  first  turns  it  yellowish,  but  subsequently  black,  (e)  Heated 
in  a  reduction-tube  with  dried  carbonate  of  soda,  it  sublimes, 
forming  a  white  ring  on  the  cool  part  of  the  tube,  which, 
under  the  microscope,  is  seen  to  consist  of  minute  globules 
of  metallic    mercury.     The  white  residue  in    the    tube    is 


280  TOXICOLOGY. 

shown   to  contain  chlorine,  by   dissolving  it   in  water  and 
applying  nitrate  of  silver. 

(2.)  As  a  liquid. — (a)  A  drop  evaporated  on  a  glass  slide 
will  yield  large,  needle-shaped  or  prismatic  crystals,  (a)  So- 
lution of  potassa  gives  a  yellow  oxide  of  mercury  ;  this, 
when  dried  and  heated  in  a  reduction-tube,  will  yield  a 
sublimate  of  mercury  globules,  with  the  evolution  of  oxygen 
gas.  (c)  Ammonia  produces  a  white  precipitate,  (d)  Iodide 
of  potassium  first  causes  a  yellow  and  immediately  afterwards 
a  bright  scarlet  precipitate,  soluble  in  an  excess  of  the  re- 
agent. When  this  iodide  of  mercury  is  dried  and  heated, 
it  volatilizes,  and  condenses  in  a  yellow  deposit,  which 
gradually  changes  to  scarlet,  (e)  Protochloride  of  tin  first 
throws  down  a  white  precipitate  (calomel),  and,  if  in  excess, 
a  dark  gray  precipitate  (metallic  mercury),  which  runs  into 
globules  on  being  boiled,  (j)  Sulphuretted  hydrogen  and 
sulphide  of  ammonium  first  cause  a  whitish  precipitate, 
soon  changing  to  red,  and  ultimately  to  black,  (g)  The 
copper  test.  A  piece  of  bright  copper  put  into  a  cold 
solution  of  corrosive  sublimate,  acidulated  with  hydrochloric 
acid,  speedily  acquires  a  silvery  white  coating  of  metallic 
mercury.  When  the  copper  slip  is  dried  and  heated  in  a 
reduction-tube,  a  sublimate  of  metallic  globules  is  obtained, 
easily  identified  by  the  microscope.  This  test  is  extremely 
delicate,  and  will  detect  the  xoios  of  a  grain,  if  the  copper 
surface  is  very  small  and  is  heated  in  a  very  small  tube. 
According  to  Wormley  (Mici'o-Chcm.  of  Poisons,  p.  339),  a 
far  smaller  quantity — even  the  ^otjW  of  a  grain — may  be 
identified  by  employing  a  very  small,  thin,  glass  tube,  the 
one-tenth  of  an  inch  in  diameter,  and  drawing  it  out,  by 
heating,  into  a  thin  capillary  neck.  The  small  fragment  of 
coated  copper  is  introduced  through  the  wider  portion  of 
the  tube  to  the  point  of  contraction,  and  the  wider  end  is 


CORROSIVE   SUBLIMATE TESTS.  281 

now  carefully  fused  shut  by  the  mouth  blowpipe,  so  as  to 
give  it  the  appearance  of  a  small  thermometer  tube,  the 
bulb  containing  the  coated  copper.  The  tube  is  now  heated 
at  the  bulb,  and  the  capillary  end  closed.  On  examination 
under  the  microscope,  a  well-defined  ring  of  mercurial 
globules  will  be  visible  on  the  capillary  tube,  just  above  the 
bulb. 

In  case  the  mercurial  sublimate  in  the  reduction-tube 
should  be  dim  and  unsatisfactory,  Tardieu  (Sur  /'  Empois., 
p.  580)  recommends  to  introduce  a  minute  crystal  of  iodine 
into  the  tube,  pushing  it  down  as  far  as  the  sublimate  with 
a  platinum  wire.  The  open  end  of  the  tube  is  then  stopped 
with  wax,  and  it  is  kept  in  a  horizontal  position  for  about 
twelve  hours,  at  a  temperature  of  300  or  400  C,  when  the 
deposit  will  assume  a  bright  scarlet  color,  due  to  the  pro- 
duction of  iodide  of  mercury.  After  removing  the  iodine, 
the  tube  may  be  gently  and  progressively  heated  from 
below  by  the  flame  of  a  spirit  lamp,  when  the  scarlet  color 
will  change  to  yellow,  and  on  cooling  the  latter  color  will 
give  place  to  scarlet  again. 

(/i)  The  galvanic  lest. — This  consists  in  winding  a  strip 
of  gold  around  a  strip  of  zinc  (or  iron)  and  placing  the  coil 
in  the  acidulated  solution.  Prof.  Guy  recommends  a  simpler 
and  equally  certain  method — to  moisten  a  narrow  slip  of 
zinc  with  water,  and  to  take  up  as  much  gold  leaf  as  will 
adhere  to  it,  and  introduce  this  into  the  acid  solution.  The 
gold  will,  in  a  short  time,  become  coated  over  with  a  silver- 
colored  coating  of  mercury.  It  is  then  to  be  carefully 
washed  and  dried,  and  heated  in  a  reduction-tube,  when  the 
usual  mercurial  sublimate  will  be  obtained.  The  gold  test 
is  generally  regarded  as  the  most  delicate  of  all. 

Toxicological  examination. — In  a  case  where  the  poison 
was  administered  in  the  solid  form,  fragments  of  it  may  be 
1  j 


282  TOXICOLOGY. 

found  in  the  stomach  yet  undissolved;  these  should  be  col- 
lected and  identified.  But  as  corrosive  sublimate  is  easily 
decomposed  by  albumen,  gluten  and  other  substances, 
much  of  it  may  be  changed  into  insoluble  compounds.  If 
the  quantity  in  solution  is  considerable,  it  may  be  extracted 
by  simply  agitating  it  with  twice  its  volume  of  ether,  and 
after  it  has  settled,  removing  the  ether  by  means  of  a  pipette, 
and  allowing  it  to  evaporate  spontaneously,  when  the  salt  will 
crystallize  in  white,  silky  prisms.  These  may  be  purified,  if 
necessary,  by  dissolving  in  water  or  alcohol,  and  again 
crystallized.  This  method  has  the  advantage  of  recovering 
the  poison  in  the  exact  state  in  which  it  was  swallowed,  with 
the  reservation,  however,  that  ether  would  act  upon  any 
mercurial  salt  in  the  presence  of  an  alkaline  chloride — e.  g., 
chloride  of  sodium — in  a  similar  manner. 

The  stomach  and  its  contents  should  be  prepared  in  the 
usual  manner,  already  described,  and  heated  with  distilled 
water  and  hydrochloric  acid.  After  proper  filtration  and 
concentration,  a  trial  test  may  be  made  with  a  strip  of  cop- 
per, allowing  this  to  remain  in  the  solution,  if  necessary,  for 
several  hours.  The  gold  test  may  be  applied  in  a  similar 
manner.  By  either  of  these  processes  the  metal  can  be 
recovered  in  a  satisfactory  manner.  The  other  tests  above 
mentioned  may  also  be  applied  as  corroborative  proofs. 

The  solid  matters  remaining,  after  straining  off  the  liquid, 
will  probably  contain  much  of  the  poison  combined  with 
organic  substances.  These  should  be  boiled  in  distilled 
water  with  hydrochloric  acid,  until  disintegrated,  then  fil- 
tered and  concentrated,  and  tested  as  above.  Another 
method  is  to  dry  the  solid  matters  thoroughly,  and  digest 
them  in  warm  nitro-muriatic  acid,  by  which  the  insoluble 
mass  is  converted  into  soluble  corrosive  sublimate.  The 
acid  liquid  is  then  evaporated  to  dryness ,  the  residue  dis- 


CORROSIVE   SUBLIMATE — DETECTION.  283 

solved  in  water  and  filtered,  and  the  usual  tests  applied ;  or 
the  corrosive  sublimate  is  dissolved  out  by  ether. 

In  the  tissues. — The  liver,  or  other  organs,  should  first 
be  crushed  in  a  mortar,  with  sufficient  alcohol  to  render 
filtration  easy.  Acidulate  the  mass  with  hydrochloric  acid, 
and  gently  warm  for  some  time ;  then  filter  through  paper, 
and  apply  the  copper  or  galvanic  test,  and  sulphuretted 
hydrogen  to  the  filtrate.  All  the  solid  portions  are  now  to 
be  mixed  with  water  and  four  parts  of  hydrochloric  acid, 
and  boiled  for  some  time ;  when  cool,  they  are  to  be  filtered 
and  the  filtrate  examined  as  above. 

Should  arsenic  happen  to  be  present  in  the  tissues  along 
with  corrosive  sublimate,  on  the  application  of  Reinsch's 
test  both  metals  will  be  precipitated  on  the  copper,  and  both 
will  sublime  from  the  latter  when  it  is  heated  in  the  reduc- 
tion-tube ;  but  in  the  cold,  mercury  alone  will  be  deposited 
on  the  copper. 

To  detect  mercury  in  the  saliva,  acidulate  about  two 
drachms  of  this  fluid  with  one-fourth  of  hydrochloric  acid, 
and  introduce  into  the  mixture  a  small  piece  of  bright  cop- 
per foil,  and  the  whole  kept  warm  for  several  hours.  The 
silvery  deposit  on  the  metal  will  indicate  the  presence  of 
mercury,  which  will  be  confirmed  by  heating  it,  when  washed 
and  dried,  in  a  reduction-tube,  and  procuring  the  character- 
istic mercurial  globules  by  sublimation. 

In  examining  the  urine,  evaporate  about  twelve  or  four- 
teen ounces  down  to  one  ounce ;  acidulate  this  with  hydro- 
chloric acid ;  filter  and  boil  the  filtrate,  and  introduce  a 
fragment  of  bright  copper,  and  confirm  as  directed  above. 

It  should  be  remembered  that  death  may  ensue  from  cor- 
rosive sublimate,  and  no  mercury  be  found  in  the  tissues,  as 
where  the  person  has  survived  for  a  number  of  days.  Also, 
as  in  the  case  of  other  poisons,  there  may  be  a   failure  to 


28-4  TOXICOLOGY. 

detect  it  in  the  stomach  after  death,  even  when  large  doses 
had  been  swallowed. 

On  the  other  hand,  the  detection  of  minute  quantities  of 
mercury  in  the  organs  is  not  always  evidence  of  poisoning, 
inasmuch  as  the  person  may  have  lately  taken  blue  pill  or 
calomel  as  a  medicine  ;  hence,  caution  should  be  exercised 
in  reference  to  this  point. 

Corrosive  sublimate  is  usually  estimated  quantitatively, 
as  a  sulphide,  by  carefully  washing  and  drying  the  pre- 
cipitate obtained  by  sulphuretted  hydrogen.  Every  ioo 
grains  of  dried  sulphide  are  equivalent  to  1 1 6. 8 1  grains  of 
anhydrous  corrosive  sublimate.  Sometimes  the  proto- 
chloride  of  tin  is  used  to  precipitate  metallic  mercury  from 
a  given  quantity  of  the  mercurial  solution.  The  globules 
should  first  be  purified  by  boiling  them  in  a  solution  of 
potassa,  and  afterwards  in  hydrochloric  acid.  Every  ioo 
grains  of  metallic  mercury  represent  135.5  grains  of  cor- 
rosive sublimate. 

Other  compounds  of  mercury  may  occasionally  prove 
poisonous,  as  the  red  and  white  precipitates,  red  oxide,  calo- 
mel, the  sulphides,  nitrates  and  sulphates. 


POISONING    BY    LEAD.  285 


CHAPTER    XX. 

POISONING  BY  LEAD. 

FREQUENCY  OF  CHRONIC  POISONING. — ACETATE  OF  LEAD. — SYMP- 
TOMS.—  TREATMENT. —  POST-MORTEM  APPEARANCES. —  PAINTERS' 
COLIC. — LEAD  PALSY. — TOXICOLOGICAL  EXAMINATION. 

In  the  metallic  state,  lead  is  not  considered  poisonous ; 
but,  as  it  is  easily  oxidized  by  the  fluids  of  the  stomach,  it 
would  soon  be  converted  into  a  deleterious  compound.  All 
i^s  salts  are  poisonous,  with  perhaps  the  single  exception  of 
the  sulphate,  which  is  very  insoluble. 

Acute  poisoning  by  lead  is  very  rare,  except  as  the  result 
of  accident.  On  the  other  hand,  chronic,  or  slow  lead- 
poisoning  is  of  frequent  occurrence,  since  there  is  no  metal 
more  constantly  and  insidiously  introduced  into  the  human 
system  than  lead,  under  its  varied  forms.  In  the  arts,  the 
workmen  in  this  metal  inhale  the  fumes  and  powders  in 
smelting  the  ores,  and  manufacturing  white  lead.  Painters, 
plumbers,  pewterers,  and  glazers  of  pottery  are  all  exposed 
to  similar  danger.  Even  sleeping  in  a  freshly-painted  room 
has  been  known  to  cause  an  attack  of  colic  and  paralysis, 
from  breathing  the  emanations  containing  carbonate  of  lead. 
Dr.  Taylor  (On  Poisons,  p.  434)  alludes  to  himself  as  having 
suffered  from  this  latter  cause. 

The  frequent  handling  of  pewter  vessels,  and  especially 
of  new  type,  has  produced  lead  palsy.  The  use  of  glazed 
pottery  is  another  source  of  contamination,  arising  from  the 
action  of  acids,  such  as  vinegar,  and  of  oils  and  fats,  also  of 
alkalies,  on   the  glaze,  which   consists   of  litharge.      Even 


286  TOXICOLOGY. 

milk  has  become  poisoned  in  this  way.  Cider  and  beer, 
drawn  through  leaden  pipes,  may  become  contaminated  in 
the  same  manner.  Wine  may  become  affected  by  contact 
with  the  shot  left  in  the  bottles  through  carelessness.  New 
rum  is  apt  to  contain  lead,  derived  from  the  leaden  worm  of 
the  still,  while  old  rum  is  free  from  this  adulteration.  This 
is  ascribed,  with  great  probability,  to  the  fact  that  old  rum, 
being  kept  in  oak  casks,  is  deprived  of  its  lead  by  the  tannin 
of  the  cask. 

Certain  medicinal  substances  often  contain  lead,  derived 
from  the  mode  of  their  manufacture ;  thus,  carbonate  of 
ammonia,  sublimed  in  leaden  vessels;  borax,  and  other  salts, 
crystallized  in  leaden  pans ;  tartaric  acid,  from  the  lead 
attached  to  the  strings  used  in  its  crystallization.  Solutions 
of  soda  and  potash,  when  kept  in  flint-glass  bottles,  soon 
become  impregnated  with  lead ;  and  the  sulphuric  acid  of 
common  use  almost  invariably  contains  lead,  derived  from 
the  leaden  chambers. 

Many  articles  in  domestic  use  are  not  unfrequently  con- 
taminated by  lead,  as  flour  (from  the  plugs  of  lead  imbedded 
in  the  millstones),  sugar,  snuff,  tobacco,  chocolate,  and  bon- 
bons— the  latter  articles  from  the  impure  tin-foil  wrappers. 

The  external  application  of  the  preparations  of  lead  is 
often  the  cause  of  slow  poisoning,  as  in  handling  the  metal, 
already  alluded  to;  the  use  of  hair  dyes  and  cosmetics;  and 
even  from  the  glazed  lining  of  hats.  The  direct  application 
of  white  lead  to  the  scalded  surface,  as  a  dressing,  has  been 
known  to  produce  symptoms  of  lead  colic. 

Probably  the  most  frequent  source  of  chronic  lead  poison- 
ing is  through  drinking  water,  which  has,  in  some  way  or 
other,  been  in  previous  contact  with  metallic  lead.  The  con- 
ditions under  which  this  occurs  should  be  thoroughly  un- 
derstood by  the  legal  physician.    Pure  distilled  water,  which 


ACETATE    OF    LEAD.  287 

in  nature  is  represented  by  rain  and  melted  snow,  in  contact 
with  lead  and  exposed  to  the  air,  speedily  acts  upon  the 
metal,  producing  a  mixture  of  the  hydrated  oxide  and  car- 
bonate of  lead,  which  are  very  poisonous.  Consequently, 
rain  water,  which  is  frequently  preserved  in  cisterns  for 
drinking  purposes,  should  never  be  collected  from  a  leaden 
roof,  nor  be  conducted  through  leaden  pipes,  nor  in  any  way 
come  in  contact  with  this  metal.  On  the  other  hand,  river 
and  spring  water,  which  always  contain  more  or  less  of  saline 
ingredients,  exert  no  deleterious  influence  upon  lead,  in  con- 
sequence of  the  preservative  action  of  the  carbonates,  sul- 
phates and  phosphates  existing  in  the  water  ;  these  form  an 
insoluble  film  or  coating  upon  the  surface  of  the  metal,  thus 
preserving  it  from  any  further  action  of  the  water.  The 
presence  of  the  chlorides,  nitrates  and  nitrites  would,  on  the 
contrary,  increase  its  corrosive  action  on  the  lead.  Free 
carbonic  acid  in  the  water  very  much  increases  the  danger 
of  contamination,  in  the  absence  of  any  protecting  salt,  In 
consequence  of  its  solvent  power  over  carbonate  of  lead. 

Another  cause  of  contamination  may  arise  from  a  gal- 
vanic action  between  lead  and  other  metals  soldered  together, 
and  especially  when  in  contact  with  carbonic-acid  water. 
Danger  also  arises  from  a  leaden  cover  being  over  a  pump 
or  cistern.  The  vapor  of  the  water  (which  is  equivalent  to 
distilled  water),  impinging  on  the  metal  surface,  dissolves 
off  the  poisonous  oxide  and  carbonate  of  lead,  which  may 
in  time  fall  into  and  contaminate  the  water. 

The  only  compounds  of  lead,  of  medico-legal  interest, 
are  the  acetate  and  carbonate. 

Acetate  of  Lead — (Sugar  of  Lead). — Occurs  in  com- 
merce in  masses  of  white,  or  light-brownish  crystals,  some- 
what resembling  loaf  sugar  in  appearance.  It  has  an  acetous 
odor,  and  a  sweetish,  astringent  taste.    Soluble  in  water;  less 


288  TOXICOLOGY. 

so  in  alcohol.  Its  aqueous  solution  becomes  milky  on  ex- 
posure to  the  air,  owing  to  the  carbonic  acid  of  the  latter. 

It  is  not  a  very  active  poison ;  it  is  much  used  in  medical 
practice,  but  its  continued  employment  has  occasionally  re- 
sulted in  bringing  on  symptoms  of  lead  poisoning. 

In  doses  of  an  ounce  or  two,  it  acts  as  a  powerful  irritant, 
causing  burning  pain  in  the  throat  and  stomach,  and  thirst, 
vomiting,  twisting,  colicky  pains,  with  tenderness  in  the  abdo- 
men, obstinate  constipation,  retraction  of  the  abdominal 
walls,  anxious  countenance,  cold  sweats  and  convulsions. 
The  urine  is  diminished  in  quantity.  In  protracted  cases, 
there  is  often  paralysis  of  one  or  more  of  the  extremities. 
Its  influence  on  the  nerve  centres  is  marked  by  the  giddi- 
ness, stupor,  convulsions  and  coma.  In  some  cases,  there 
is  purging  of  bloody  matters,  though  usually  the  fecal  dis- 
charges are  hard,  dry  and  black.  The  peculiar  blue  line 
upon  the  edge  of  the  gums,  characteristic  of  chronic  lead 
poisoning,  may  sometimes  be  observed  in  acute  cases. 

The  fatal  quantity  is  uncertain;  an  ounce  has  been 
swallowed  with  impunity,  though  a  less  quantity  has 
occasioned  alarming  symptoms.  The  fatal  period  is  equally 
uncertain,  varying  from  a  few  hours  to  several  days. 

The  proper  antidotes  are  the  soluble  alkaline  and  earthy 
•sulphates,  especially  the  sulphate  of  magnesia,  which  forms 
the  insoluble  sulphate  of  lead.  At  first,  however,  vomiting 
should  be  promoted  by  sulphate  of  zinc ;  afterwards,  opium 
and  castor  oil  may  be  required.  The  urine  should  be 
frequently  examined  for  the  presence  of  the  metal. 

Post-mortem  appearances. — Often  no  well-marked  lesions 
are  discoverable.  Again,  more  or  less  inflammation  of  the 
alimentary  tract  has  been  observed.  Sometimes  the  inner 
coat  of  the  stomach  and  bowels  is  covered  with  a  thick, 
whitish  layer  of  mucus  mixed  with  the  salt  o^  lead,  beneath 


POISONING    BY    LEAD LEAD    COLIC.     '  289 

which  the  membrane  is  reddened,  or  even  abraded.  The 
intestines  are  generally  found  contracted.  As  regards 
chronic  cases,  there  is  nothing  very  definite  to  record, 
except  the  contraction  of  the  large  intestines,  and  the 
flabby  and  whitish  appearance  of  the  muscles  specially 
affected. 

CJironic  poisoning. — This  may  result  from  the  continued  in- 
ternal use  of  any  of  the  salts  of  lead  ;  but  it  is  more  frequently 
produced  among  artisans  working  in  white  lead  and  litharge, 
or  by  the  accidental  introduction  of  the  metal  into  the  sys- 
tem through  drinking-water,  or  articles  of  food.  The  earlier 
symptoms  are  grouped  under  the  names  of  Lead  Colic, 
Painters'  Colic,  or  Colica  Pictonnm  ;  the  later  symptoms  are 
named  Lead  Palsy. 

Lead  colic. — The  earlier  symptoms  are  obstinate  consti- 
pation and  indigestion,  with  great  depression.  Then  there 
is  a  feeling  of  twisting,  grinding  pain  about  the  umbilicus, 
which  may  be  rather  relieved  by  pressure.  The  abdomen 
is  hard  and  retracted  ;  sometimes  there  are  scanty,  hard 
evacuations,  with  much  suffering.  The  urine  is  scanty,  and 
voided  with  difficulty.  The  countenance  is  dull  and  anxious ; 
skin  cold  and  clammy;  pulse  about  natural;  respiration 
quick  and  catching;  loss  of  appetite,  with  dryness  of  mouth 
and  throat ;  the  breath  is  fetid,  and  often  a  metallic  taste  in 
the  mouth.  A  characteristic  sign  of  saturnine  poisoning 
is  the  blue  line  at  the  margin  of  the  gums,  where  they  join 
the  teeth,  especially  noticeable  on  the  upper  incisors.  This 
is  due  to  the  deposition  of  the  metal  in  the  form  of  a  sul- 
phide in  the  capillaries  of  the  gums,  as  can  be  shown  by  the 
microscope.  Some  other  metals,  as  silver  and  mercury, 
occasionally  produce  a  somewhat  similar  blue  line,  and  it  is 
wanting  in  some  exceptional  cases  of  chronic  lead-poisoning. 
When  once  established,  this  symptom  is  very  persistent. 


290  TOXICOLOGY. 

Lead  palsy. — Lead  colic,  if  allowed  to  continue  un- 
checked, is  very  apt  to  terminate  in  paralysis,  especially 
after  repeated  attacks  of  the  former.  Again,  it  may  come 
on  without  any  previous  attack  of  colic.  It  usually  affects 
the  upper  extremities.  At  first  there  is  a  dull,  numb  feel- 
ing in  the  skin  of  the  fingers  and  forearms,  trembling  of  the 
arms  and  legs,  unsteadiness  of  gait,  loss  of  power  in  the 
hands  and  arms,  which  gradually  waste  away.  The  ex- 
tensors are  more  affected  than  the  flexors,  so  that,  when  the 
arm  is  raised,  the  hand  drops  by  its  own  weight,  whence 
the  common  name  of  "  wrist  drop  "  for  this  disease.  If  un- 
checked, brain  symptoms  present  themselves,  such  as  giddi- 
ness, torpor  and  apoplexy;  sometimes  there  are  epileptic 
fits,  oedema,  albuminuria  and  convulsions,  ending  in  coma 
and  death. 

Lead  has  been  found,  after  death,  in  the  brain,  and 
especially  in  the  gray  matter  of  the  spinal  cord,  also  in  the 
bones,  liver  and  kidneys.  Doubtless,  many  cases  of  obscure 
spinal,  cerebral  and  cardiac  disease  are  really  owing  to 
chronic  lead  poisoning — the  metal  having  been  introduced 
unsuspectedly  into  the  system. 

Chemical  analysis. — I.  In  the  solid  state. — Heated  in  a 
test-tube,  it  evolves  an  acetous  odor,  and  fuses  into  a  white 
mass ;  if  the  heat  is  continued,  it  again  fuses  and  slowly 
chars,  and  is  converted  into  a  reddish-brown  mixture  of  the 
oxides  of  lead.  Heated  on  charcoal,  before  the  blowpipe, 
it  is  converted  into  globules  of  metallic  lead,  with  a  sur- 
rounding incrustation  of  yellow  oxide.  A  fragment  dropped 
into  a  solution  of  the  iodide  of  potassium  instantly  turns 
yellow;  touched  with  sulphide  of  ammonium  it  immediately 
is  blackened. 

II.  /;/  the  liquid  state. — (i)  A  drop,  evaporated  on  glass, 
yields   opaque   needles,  which  turn   yellow  when   touched 


LEAD — TOXICOLOGICAL    EXAMINATION.  201 

with  a  drop  of  iodide  of  potassium  solution,  or  solution  of 
bichromate  of  potassium;  or  black,  by  sulphide  of  ammo- 
nium. (2)  Dilute  sulphuric  acid  causes  a  white  precipitate, 
soluble  in  hot  hydrochloric  acid,  and  in  large  excess  of 
potassa  and  soda.  (3)  Iodide  of  potassium  gives  a  bright 
yellow  precipitate,  soluble  in  boiling  water,  which  deposits 
it  in  brilliant  yellow  scales,  on  cooling.  The  iodide  of  lead 
is  also  soluble  in  potassa  and  strong  hydrochloric  acid. 
(4)  Bichromate  of  potassium  gives  a  bright  yellow  precipi- 
tate. (5)  Sulphuretted  hydrogen  is  the  most  delicate  test, 
revealing,  according  to  Taylor,  a  quarter  of  a  grain  of  this 
salt  in  a  gallon  of  water.  The  black  sulphide  is  confirmed 
by  heating  it  on  charcoal,  before  the  blowpipe ;  or  by  dis- 
solving it  in  nitric  acid,  by  the  aid  of  heat,  evaporating  to 
dryness,  dissolving  in  water,  and  applying  the  usual  tests. 
(6)  The  galvanic  test. — A  drop  or  two  of  the  solution, 
slightly  acidified  with  acetic  acid,  is  put  into  a  platinum 
capsule,  and  a  strip  of  zinc  is  made  to  touch  the  platinum 
through  the  liquid  ;  crystals  of  metallic  lead  are  deposited 
on  the  zinc ;  or  a  fragment  of  zinc  may  be  placed  in  the  lead 
solution  in  a  watch  glass,  when  very  soon  metallic  lead  will 
be  deposited  upon  the  zinc  in  an  arborescent  form.  A  salt 
of  tin,  under  similar  circumstances,  would  yield  an  arbores- 
cent deposit  of  tin.  Hence,  the  metallic  deposit  must  be 
further  tested  by  dissolving  it  in  nitric  acid,  and  applying 
the  usual  tests. 

Other  tests  of  minor  importance  are  potassa  and  am- 
monia, oxalate  of  ammonium,  alkaline  carbonates,  and  red 
and  yellow  prussiate  of  potassium. 

Toxicological  examination. — As  acetate  of  lead  is  easily 
decomposed  by  many  organic  substances,  such  as  albumen, 
casein,  mucus,  etc.,  the  poison  may  exist  both  in  the  soluble 
and  insoluble  condition.     As  a  trial  test,  a  good  plan  is  to 


202  TOXICOLOGY. 

wet  a  piece  of  bibulous  paper  in  the  suspected  solution  and 
expose  it  to  a  jet  of  sulphuretted  hydrogen  gas,  which  will 
blacken  it,  if  it  contains  any  lead.  If  the  presence  of  this 
metal  be  indicated,  the  mixture  should  be  acidulated  with 
pure  nitric  acid,  and  boiled  for  some  time ;  when  cold,  it 
should  be  filtered,  and  the  solids  on  the  filter  thoroughly 
washed,  and  reserved  for  future  examination.  Concentrate 
the  filtrate  by  evaporation,  and  treat  with  sulphuretted  hy- 
drogen ;  allow  the  precipitated  sulphide  of  lead  to  collect, 
pour  off  the  supernatant  water,  boil  in  dilute  nitric  acid,  add 
sufficient  distilled  water,  filter,  and  apply  the  usual  tests 
(p.  291). 

The  solids  on  the  filter  should  be  dried,  and  incinerated 
in  a  porcelain  capsule;  dissolve  the  ash  by  heat  in  dilute 
nitric  acid,  filter,  and  treat  with  sulphuretted  hydrogen,  and 
prove  the  precipitated  sulphide. 

If  an  alkaline  sulphate  has  been  given  as  an  antidote,  a 
white  precipitate  of  sulphate  of  lead  may  be  found  in  the 
stomach.  This  should  be  collected  and  boiled  with  pure 
potassa  (proven  itself  to  contain  no  lead),  and  the  solution 
tested  with  sulphuretted  hydrogen. 

The  solid  organs  (liver,  spleen,  etc.)  may  be  examined 
either  by  boiling  with  nitric  acid  and  water,  evaporating  to 
dryness,  incinerating  in  a  porcelain  crucible  and  again  dis- 
solving by  heat  and  dilute  nitric  acid,  or  by  directly 
incinerating  them  in  a  porcelain  crucible  and  dissolving  out 
the  lead  with  strong  nitric  acid,  evaporating  to  dryness, 
diluting  with  water,  and  precipitating  with  sulphuretted 
hydrogen. 

As  lead  remains  in  the  system  for  a  considerable  time,  in 
case  of  the  detection  of  only  a  minute  quantity  in  the  body 
after  death,  inquiry  should  always  be  instituted  in  reference 
to  the  possibility  of  its  accidental  introduction  into   the  sys- 


LEAD DETECTION.  293 

tern   through  the  occupation,  mode  of  living,  etc.,  of  the 
individual. 

The  examination  of  the  urine  should  never  be  neglected, 
seeing  that  lead  is  eliminated  from  the  system  chiefly 
through  this  secretion.  From  fifteen  to  twenty  ounces  of 
urine,  acidulated  with  nitric  acid,  should  be  evaporated  to 
dryness,  and  incinerated  as  above  directed,  and  the  ash 
treated  as  already  described. 

For  the  detection  of  lead  in  sweetmeats,  etc.,  suspected 
of  being  colored  with  this  metal,  slightly  moisten  them  with 
water  and  put  them  on  a  plate,  placing  in  the  centre  a  little 
capsule  containing  about  a  drachm  of  sulphide  of  ammo- 
nium, and  cover  the  whole  with  a  tumbler.  If  lead  be 
present,  the  sweetmeats  will,  after  a  short  time,  be  blackened 
by  the  sulphuretted  hydrogen  gas  evolved  {Woodman  and 
Tidy). 

Lead  is  quantitatively  determined  as  a  sulphide.  Every 
100  parts  of  pure,  dried  sulphide  represent  93.31  parts  of 
the  oxide,  or  158.37  parts  of  crystals  of  the  acetate. 


294  TOXICOLOGY. 


CHAPTER   XXI. 

POISONING   BY  COPPER. 

ACCIDENTAL  POISONING. — SALTS  OF  COPPER. — FATAL  DOSE. — TREAT- 
MENT.— MORBID  APPEARANCES. —  CHEMICAL  ANALYSIS. —  TOXICO- 
LOGICAL    EXAMINATION. 

Copper,  like  many  of  the  other  metals,  is  not  poisonous 
in  the  metallic  state ;  but  if  taken  into  the  stomach,  it  is 
soon  corroded,  and  forms  highly  poisonous  compounds. 
Copper  coins,  sometimes  swallowed  by  children,  may  thus 
produce  dangerous  results.  The  inhalation  of  copper  alloy 
in  fine  powder,  by  artisans  who  work  in  what  is  termed 
gold  printing,  causes  serious  results,  such  as  constriction 
and  heat  of  throat,  vomiting,  loss  of  appetite,  and  severe 
itching  of  the  parts  of  the  body  covered  with  hair,  which, 
on  examination,  are  found  to  be  of  a  deep  green  color 
(Falconer,  on  Copper  Poisoning). 

Cases  of  accidental  copper-poisoning  can  frequently  be 
traced  to  want  of  cleanliness  in  cooking,  or  to  keeping  food 
in  copper  vessels,  particularly  such  articles  as  contain  a 
vegetable  acid,  as  vinegar,  an  alkaline  chloride,  as  common 
salt,  or  any  kind  of  oil  or  fat.  So  long  as  copper  utensils 
are  kept  perfectly  clean  and  bright,  no  risk  is  incurred  in 
using  them  ;  but  if  cleanliness  is  neglected,  a  deposit  of  the 
green  carbonate  collects,  which  is  very  poisonous,  and  will 
contaminate  any  food  with  which  it  may  come  in  contact. 
There  is  no  risk  in  boiling  articles  of  food  or  preserves  in 
clean  copper  vessels,  although  it  is  unsafe  to  keep  these 
articles,  cold,  in  the  same  vessels ;  in  the  latter  case,  the 
atmospheric  air  acts  upon  the  metal  at  the  point  of  contact 


POISONING    BY    COPPER.  295 

of  the  contained  substance.  Dr.  Falconer  gives  an  instruc- 
tive example  of  this.  A  servant  left  some  sour-krout,  for 
only  a  couple  of  hours,  in  a  copper  pan  which  had  lost  its 
tinning.  Her  mistress  and  daughter,  who  ate  of  the  cab- 
bage, died  after  twelve  hours'  sickness.  Wildberg  found 
the  cabbage  so  strongly  impregnated  with  copper  that  it 
was  detected  by  metallic  iron. 

The  inference  from  the  above  facts  would  be  that  it  is 
extremely  unsafe  to  employ  copper  vessels  either  for  cook- 
ing, or  still  more  so  for  preserving  articles  of  food.  Even 
turned  copper  vessels  are  not  safe,  because  the  tinning  con- 
sists of  an  alloy  of  tin  and  lead,  and  the  latter  metal  might, 
in  its  turn,  prove  a  source  of  danger. 

The  alloy  termed  Dutcli  metal,  used  for  ornamenting  cakes 
and  confectionery  as  a  substitute  for  gold  leaf,  may  also 
prove  a  source  of  poisoning,  as  likewise  the  blue  and  green 
papers  used  as  wrappers  for  bon-bons,  although  the  chief 
source  of  danger  from  the  latter  arises  from  the  arsenic  con- 
tained in  their  composition. 

The  fine  green  color  on  many  samples  of  pickles  and 
preserved  fruits  is  owing  to  the  adulteration  of  a  salt  of 
copper,  as  verdigris  or  blue  vitriol.  This  may  be  easily  de- 
tected by  placing  the  suspected  article  in  ammonia,  when,  if 
copper  be  present,  it  will  turn  blue.  A  simpler  method  is  to 
plunge  a  bright  needle  into  the  article;  if  copper  be  present, 
it  will  speedily  receive  a  reddish  coating  of  the  metal. 

All  the  cupreous  salts  are  poisonous ;  those  of  most 
medico-legal  importance  are  the  sulphate  (blue  vitriol,  blue 
stone),  and  the  sub-acetate  (verdigris).  The  arsenite  and 
aceto-arscnitc  have  already  been  described  under  the  head 
of  Arsenic.  What  is  commonly  called  verdigris  is  the  car- 
bonate of  copper,  which  is  produced  by  the  action  of  moist 
air  on  the  metal,  or  on  brass. 


296  TOXICOLOGY. 

The  salts  of  copper  ai  i  rarely  used  for  homicidal  poi- 
soning, as  they  can  be  so  readily  recognized,  both  by  their 
color  and  taste.  Occasionally,  they  have  been  taken 
suicidally,  and  more  rarely  by  accident.  The  sulphate  has 
been  employed  as  an  abortive. 

Symptoms. — The  sulphate  may  be  taken  as  a  type  of  all 
the  salts.  In  large  doses  it  produces  speedy  and  powerful 
vomiting,  which  would  probably  expel  the  whole  of  the 
poison,  and  thus  prevent  a  fatal  result.  There  are  pain  in  the 
stomach  and  bowels,  great  thirst,  purging,  headache,  pros- 
tration, small,  frequent  pulse,  with  increased  flow  of  saliva. 
The  matters  vomited  are  bluish  or  greenish  ;  those  from  the 
bowels  are  greenish,  and  tinged  with  blood.  Sometimes 
there  are  severe  cramps  and  convulsions.  There  is  also 
suppression  of  urine,  and  in  fatal  cases,  paralysis  and  tetanus 
have  preceded  death.  Jaundice  is  also  an  occasional  result. 
Dr.  Tidy  speaks  of  it  as  "  the  specially  diagnostic  symptom 
of  copper  poisoning."  It  is  not  met  with  in  poisoning  by 
either  arsenic  or  mercury. 

The  symptoms  of  slow  poisoning  (which  is  generally  the 
result  of  the  accidental  introduction  of  the  metal  in  articles 
of  food)  are  an  acrid,  styptic,  coppery  taste  in  the  mouth, 
dry  and  parched  tongue,  coppery  eructations,  continual 
spitting,  nausea  and  vomiting,  colicky  pains  in  the  bowels, 
diarrhoea  of  bloody  stools,  with  tenesmus,  great  thirst,  heat  of 
skin,  small  and  tense  pulse,  scanty  urine,  headache,  vertigo, 
faintness,  cramps  of  the  legs  and  convulsions;  occasionally, 
jaundice  and  a  blue  line  on  the  margin  of  the  gums. 

Fatai,  dose. — Not  positively  determined.  Half  an  ounce 
of  verdigris  has  proved  fatal,  and  an  ounce  of  the  sulphate; 
but  larger  quantities  have  been  swallowed  without  produc- 
ing death.  The  usual  emetic  dose  is  five  to  fifteen  grains. 
The  usual  fatal  period  is  from  four  to  twelve  hours. 


COPPER CHEMICAL    ANALYSIS.  297 

Treatment. — Free  vomiting  should  be  assisted  by  the  use 
of  warm  diluent  drinks.  The  best  antidote  is  albumen  in 
the  form  of  white  of  eggs,  as  for  corrosive  sublimate.  Milk 
is  also  very  useful. 

Morbid  appearances. — These  indicate  the  action  of  a 
powerful  irritant  to  the  mucous  membrane  of  the  alimen- 
tary canal,  from  the  throat  downward.  The  lining  mem- 
brane of  the  stomach  is  inflamed,  softened,  and  sometimes 
ulcerated.  It  usually  exhibits  a  bluish  or  greenish  appear- 
ance, due  to  the  color  of  the  salt  taken.  The  same  is  true, 
also,  of  the  intestines.  As  a  somewhat  similar  appearance 
may  result  from  the  presence  of  bile,  it  is  proper  to  distin- 
guish between  them  by  the  addition  of  ammonia,  which  will 
impart  a  deep  blue  color  if  copper  is  present,  but  will  cause 
no  change  in  the  green  color,  if  due  to  bile.  Perforations 
have  been  found  in  the  small  intestines ;  the  rectum  is  occa- 
sionally ulcerated,  and  the  lungs  congested. 

Chemical  analysis. — All  the  salts  of  copper  possess  either 
a  blue  or  green  color.     Only  a  few  other  metallic  salts  are 
thus   colored,  as   some  of  the   cobalt  salts,  blue,  and  some 
I  of  those  of  nickel,  chronium  and  uranium,  green.     When 
I    heated  in  the  blowpipe  flame,  they  impart  to  it  a  beautiful 
"green  color ;  and  when  heated  on  charcoal,  with  dry  carbo- 
nate of  soda,  before   the   blowpipe,   globules    of   metallic 
copper  are  obtained. 

The  sidpJiatc,  or  blue  vitriol,  occurs  in  large,  handsome 
crystals,  efflorescent,  soluble  in  water,  having  a  nauseous, 
styptic,  metallic  taste.  The  verdigris  of  commerce  occurs 
in  masses  of  a  light  green,  or  bluish-green  color.  It  is  a 
mixture  of  the  sub-acetate  and  other  acetates  of  copper.  It 
is  soluble  in  water  and  in  dilute  acids. 

(i)  Ammonia  gives  to  the  solution  a  bluish-white  amor- 
phous precipitate — hydrated  oxide  of  copper,  which  is  re- 
14 


298  TOXICOLOGY. 

dissolved  by  an  excess  of  the  precipitant,  yielding  a  beautiful, 
clear,  dark  purple-blue  solution  ;  this  color  is  immediately 
removed  by  an  acid.  The  salts  of  cobalt,  nickel  and 
chromium  give  somewhat  similar  results. 

(2)  Ferrocyanide  of 'potassium  gives  a  reddish-brown  pre- 
cipitate, insoluble  in  excess  of  the  reagent,  but  soluble  in 
ammonia.  If  the  copper  solution  be  very  dilute,  no  pre- 
cipitate may  take  place,  but  only  the  distinct  brownish-red 
discoloration.  We  have  found  this  test  rather  more  delicate 
than  that  of  ammonia. 

(3)  Sulphuretted  hydrogen,  or  sulphide  of  ammonium 
yields  a  brownish-black  precipitate  of  the  sulphide.  This 
should  be  corroborated  by  boiling  in  nitric  acid,  evaporating 
to  dryness,  dissolving  in  water,  and  applying  the  usual  tests. 

(4)  The  iron  test. — This  simple  and  satisfactory  test  con- 
sists in  immersing  a  piece  of  bright  iron  or  steel  in  a 
slightly  acidulated  solution  of  copper,  when,  sooner  or 
later,  according  to  the  strength  of  the  solution,  it  will 
acquire  a  red  coating  of  metallic  copper.  If  the  solution  be 
very  dilute,  it  should  be  concentrated  by  heat,  and  a  very 
small  iron  surface  should  be  exposed  ;  a  fine  sewing  needle 
may  be  suspended  in  it  for  some  hours.  After  it  has 
received  the  copper  coating,  it  may  be  removed  and  put 
into  a  porcelain  capsule,  with  a  little  ammonia,  which,  in  a 
short  time,  will  assume  a  blue  color. 

(5)  The  galvanic  test  consists  in  placing  the  copper  solu- 
tion, slightly  acidulated,  in  a  platinum  dish,  and  touching 
the  latter,  through  the  liquid,  with  a  piece  of  zinc.  The 
metallic  copper  will  be  deposited  on  the  platinum,  in  the 
form  of  a  reddish  incrustation.  The  latter  may  be  dissolved 
off  the  platinum  by  dilute  nitric  acid,  evaporating  to  dry- 
ness, moistening  it  with  water,  and  testing  it  as  above  di- 
rected. 


COPPER — TOXICOLOGICAL   EXAMINATION.  299 

(6)  The  blowpipe,  as  already  mentioned. 

Toxicological  examination. — A  portion  of  the  copper  may 
be  found  in  a  soluble,  and  some  in  an  insoluble  state.  The 
liquid  part  has  usually  a  bluish  or  greenish  color.  This 
should  be  filtered,  concentrated  by  heat,  and  a  trial  test,  by 
means  of  a  bright  sewing  needle,  applied.  Any  reddish  de- 
posit on  the  latter  should  be  proved,  as  above  mentioned. 
Sometimes  the  needle  may  acquire  a  reddish  coating  simply 
from  the  oxide  of  iron:  ammonia  will  serve  to  distinguish 
them.  If  a  large  amount  of  copper  should  be  indicated, 
sulphuretted  hydrogen  should  be  passed  through  it  until  all 
the  metal  is  precipitated  as  a  sulphide.  This  is  to  be  treated 
after  the  manner  before  described.  If  the  amount  of  copper 
be  extremely  small,  the  galvanic  test  is  the  most  suitable. 
The  filtered  liquid,  acidified  with  sulphuric  acid,  is  placed  in 
a  platinum  capsule,  and  fragments  of  pure  zinc  are  put  into 
it;  wherever  there  are  points  of  contact  between  the  two 
metals,  there  will  be  a  reddish  deposit  on  the  platinum.  This 
should  be  washed,  and  the  copper  dissolved  off  with  a  drop 
or  two  of  dilute  nitric  acid.  The  nitric  solution  is  to  be 
evaporated  to  dryness,  diluted  with  water,  and  tested  as 
before  described. 

If  neither  of  the  above  tests  reveal  the  presence  of  copper, 
it  cannot  be  present  in  the  liquid  matters;  but  the  solids 
may  possibly  contain  it.  These  should  be  boiled  with  dilute 
hydrochloric  acid  and  water,  filtered,  concentrated  by  heat, 
and  tested. 

Traces  of  arsenic  are  sometimes  found  in  the  sulphate; 
when  the  latter  has  been  taken  as  a  vomit,  traces  of  this 
substance  have  been  discovered  in  the  matters  vomited,  and 
in  the  stomach  (Taylor). 

In  searching  for  the  salts  of  copper  in  the  stomach,  this 
organ  should  be  carefully  examined  for  blue  or  green  par- 
ticles.    After  treating  the  stomach  and  its   contents  in  the 


300  TOXICOLOGY. 

usual  manner,  with  the  addition  of  water  and  hydrochloric 
acid,  and  filtering  and  concentrating  by  heat,  the  iron  and 
galvanic  tests  may  be  used  as  trial  tests.  Sulphuretted  hy- 
drogen gas  should  then  be  passed  through  the  liquid  until 
all  the  sulphide  of  copper  is  precipitated.  This  should  be 
boiled  in  dilute  nitric  acid,  evaporated  to  dryness;  if  much 
organic  matter  is  present,  it  should  be  moistened  with  strong 
nitric  acid  and  heated  until  all  the  organic  matter  is  de- 
stroyed. The  dry  residue  is  now  dissolved  in  dilute  nitric 
acid,  and  again  evaporated  to  dryness,  dissolved  in  water, 
and  the  usual  tests  applied. 

In  the  organs. — These  should  be  finely  divided  and 
thoroughly  dried,  and  then  incinerated  in  a  porcelain 
crucible,  and  the  resulting  ash  treated  with  pure  hydro- 
chloric acid  by  heat,  and  then  evaporated  to  dryness ;  dis- 
solve in  water,  and  apply  the  usual  tests.  Copper  remains 
longer  than  arsenic  in  the  tissues  and  organs ;  as  long  as 
sixty  days  in  the  liver  and  lungs,  according  to  M.  L.  Orfila. 

In  the  urine. — Evaporate  six  to  eight  ounces  to  dryness ; 
treat  the  residue  with  the  nitric  acid  and  chlorate  of  potas- 
sium, with  the  aid  of  heat,  to  complete  incineration.  Dis- 
solve the  resulting  ash  in  hot  dilute  nitric  acid,  and  evapo- 
rate to  dryness.  Dissolve  the  residue  in  warm  water,  and 
test  as  above. 

Copper  is  not  a  normal  constituent  of  the  human  body. 
It  exists  in  minute  proportions  in  certain  vegetables,  which, 
doubtless,  obtain  it  from  the  soil. 

The  discovery  of  faint  traces  of  copper  in  the  body  after 
death  is  no  proof  of  copper-poisoning,  since  it  may  have 
been  introduced  into  the  system  accidentally,  either  through 
the  food,  or  otherwise. 

Copper  is  determined  quantitatively  as  the  black  oxide, 
every  ioo  parts  of  which  are  equivalent  to  314.21  parts  of 
crystallized  sulphate. 


POISONING    BY   ZINC.  301 


CHAPTER   XXII. 

POISONING  BY  ZINC,  BISMUTH,  TIN,  IRON  AND    CHROMIUM. 
SECTION  I.— POISONING  BY  ZINC. 

Cases  of  zinc-poisoning  are  comparatively  rare.  In  the 
metallic  state,  zinc  is  probably  inert ;  but  if  swallowed,  it 
would  soon  be  acted  upon  in  the  stomach,  and  converted 
into  a  salt,  where  it  might  occasion  serious  results.  The 
sulphate  and  chloride  are  the  preparations  most  likely  to 
produce  poisonous  effects. 

The  zinc  of  commerce  {spelter)  is  apt  to  contain  arsenic 
and  other  impurities. 

Sulphate  of  zinc — White  vitriol. — A  white,  crystalline, 
soluble  salt.  It  has  a  metallic,  astringent  taste  ;  effloresces 
on  exposure  to  the  air.  It  acts  as  a  prompt,  active  emetic, 
without  causing  much  depression  of  the  system  ;  hence,  is 
indicated  in  cases  of  narcotic  poisoning.  It  is  used  in  small 
doses  as  a  nerve  tonic,  and  the  system  soon  acquires  a 
tolerance  of  the  medicine.  As  much  as  two  scruples  three 
times  a  day,  have  been  given  for  a  period  of  three  weeks,  in 
a  case  of  epilepsy. 

Poisonous  dose. — Half  an  ounce,  to  an  ounce. 

Symptoms. — A  strong,  metallic  taste,  attended  with  a 
burning  sensation,  and  constriction  of  the  throat,  nausea, 
violent  vomiting,  intense  pain  of  stomach  and  bowels, 
purging,  small  and  frequent  pulse,  great  anxiety,  cold 
sweats,  extreme  prostration,  dilated  pupils,  coma  and  death. 
Experiments  on  animals  show  it  to  be  a  powerful  heart 
depressant. 


302  TOXICOLOGY. 

Fatal  period. — A  case  is  reported  by  Wormley,  of  a  woman 
who  swallowed  by  mistake  for  Epsom  salt,  an  ounce  and  a 
half  of  this  salt,  and  death  ensued  in  thirteen  hours  and  a 
half. 

Post-mortem  appearances. — Decided  evidences  of  inflam- 
mation in  the  mucous  membrane  of  the  alimentary  canal, 
such  as  redness,  softening,  ecchymoses,  and  sometimes 
ulceration ;  a  yellowish,  pultaceous  matter  covering  the 
inner  surface  of  the  stomach  and  bowels;  congestion  of  the 
brain  and  membranes,  also  of  the  lungs,  with  bloody  effusion 
into  the  pleura,  and  a  distended,  flabby  heart. 

Chloride  of  zinc. — In  strong  solution,  this  is  known  as 
"Sir  William  Burnett's  Disinfecting  Fluid."  It  is  much 
used  as  a  deodorizer.  It  contains  about  two  hundred  grains 
of  the  salt  to  the  ounce  of  water.  It  is  a  powerful  corro- 
sive, and  has  frequently  caused  death  when  taken  by  mis- 
take or  suicidally. 

The  symptoms  are,  in  general,  the  same  as  those  produced 
by  the  sulphate,  only  much  more  intense  in  their  character, 
and  resembling  somewhat  those  of  the  mineral  acids.  They 
come  on  immediately  after  swallowing ;  the  matters  vomited 
and  purged  are  frequently  tinged  with  blood,  and  mixed 
with  shreds  of  mucous  membrane  ;  froth  may  issue  from  the 
mouth,  and  a  white  appearance  of  the  inside  of  this  cavity 
be  noticed.     There  may  also  be  loss  of  voice. 

Fatal  period. — Dr.  Taylor  records  the  most  rapidly  fatal 
case — four  hours.  On  the  other  hand,  the  case  may  become 
chronic,  lasting  for  years,  and  ending  in  stricture  of  the 
oesophagus  and  exhaustion. 

Post-mortem  lesions. — In  addition  to  the  usual  inflam- 
matory signs,  those  of  a  corrosive  will  be  noticed,  such  as 
erosion  or  destruction  of  the  coats  of  the  stomach.  Some- 
times these  are  hard  and  leathery,  thickened  and  corrugated. 


ZINC TOXICOLOGICAL   EXAMINATION.  303 

The  pylorus  has  been  found  constricted,  and  appearing  as  if 
cauterized.  Constriction  of  the  oesophagus  has  also  been 
noticed,  together  with  a  softened  condition  of  its  mucous 
membrane.  The  brain  and  lungs  are  congested ;  the  heart 
not  affected,  but  usually  distended.  The  blood  dark  and 
uncoagulated. 

Treatment. — Assist  the  evacuation  of  the  poison  by  the 
free  use  of  mucilaginous  drinks.  The  best  antidote  is 
albumen,  as  in  corrosive  sublimate  and  copper-poisoning. 
Opium  should  be  given,  to  combat  the  irritation. 

Chemical  analysis. — In  the  solid  state,  the  sulphate  may  be 
distinguished  from  Epsom  salt  and  oxalic  acid  (which  it 
much  resembles  in  appearance),  by  exposing  a  small  frag- 
ment mixed  with  carbonate  of  soda  on  a  piece  of  charcoal, 
to  the  flame  of  the  blowpipe  ;  it  quickly  fuses,  and  the  vapor 
forms  an  incrustation  on  the  charcoal,  which  is  first  yellow, 
and  becomes  white  on  cooling.  Heated  with  cobalt  under 
the  blowpipe,  the  fused  bead  of  zinc  has  a  green  color. 

In  solution,  (i)  The  alkalies  precipitate  the  white  hydratcd 
oxide ',  which  is  soluble  in  excess  of  the  precipitant.  (2)  The 
alkaline  carbonates  throw  down  the  white  carbonate,  in- 
soluble in  excess  of  the  precipitant,  but  soluble  in  excess  of 
carbonate  of  ammonia.  (3)  Ferrocyanide  of  potassium  gives 
a  white  precipitate.  (4)  Sulphuretted  hydrogen  throws 
down  the  white  sidphide,  soluble  in  hydrochloric  acid.  This 
should  always  be  verified  by  dissolving  it  in  hot  hydro- 
chloric acid,  filtering,  diluting  and  subjecting  it  to  the  other 
tests.  (5)  The  galvanic  test. — Place  the  solution  on  a 
platinum  capsule,  and  touch  it  with  a  piece  of  magnesium, 
when  the  metal  will  be  deposited  on  the  platinum. 

Toxicological  examination. — In  a  case  of  suspected  poi- 
soning, it  should  always  be  remembered  that  sulphate  of 
zinc   may  have  been  administered    as  an    emetic ;    hence, 


304  TOXICOLOGY. 

although  discovered  in  the  body  after  death,  it  may  not  have 
been  the  actual  cause  of  death.  If  found,  other  poisons 
should  also  be  sought  for.  The  organic  matters,  along  with 
a  little  acetic  acid,  should  be  gently  heated  for  some  time,  in 
order  to  dissolve  out  the  zinc  that  may  have  combined  with 
albumen,  fibrin,  etc.  After  cooling,  the  solution  should  be 
filtered  and  concentrated,  and  then  heated  with  sulphuretted 
hydrogen.  The  precipitated  sulphide  is  collected  on  a 
filter,  washed  and  dissolved  in  strong  nitric  acid.  The 
nitrate  is  evaporated  to  dryness,  dissolved  in  water,  and 
subjected  to  the  usual  tests. 

As  the  preparations  of  zinc  usually  contain  iron,  the 
presence  of  the  latter  metal  will  more  or  less  modify  the 
reactions  of  the  former.  The  iron  may  be  separated  by  an 
excess  of  ammonia,  which  will  precipitate  the  oxide  of  iron, 
whilst  it  retains  the  zinc  oxide  in  solution. 

The  tissues  (liver,  kidney,  spleen,  etc.)  may  be  examined 
either  by  boiling  with  nitric  acid,  evaporating  to  dryness 
and  adding  small  quantities  of  nitric  acid,  and  heating  until 
all  the  organic  matter  is  destroyed ;  or  else  by  incinerating 
the  perfectly  dried  viscera  in  a  porcelain  crucible,  and  treat- 
ing the  resulting  ash  with  nitric  acid  ;  evaporating  to  dry- 
ness, and  dissolving  the  residue  in  water ;  acidulate  with 
hydrochloric  acid ;  again  evaporate  to  dryness  ;  dilute  with 
water,  and  apply  the  usual  tests. 

Since  chloride  of  zinc  is  often  employed  for  embalming 
the  dead,  the  discovery  of  zinc  in  the  body  after  death  might 
possibly  be  ascribed  to  this  cause. 

Quantitative  estimate. — Zinc  is  usually  determined  as  an 
oxide.  The  boiling  solution  is  precipitated  with  carbonate 
of  soda.  The  precipitate  is  collected  on  a  filter,  washed  and 
dried,  and  then  ignited.  The  protoxide  is  then  weighed. 
Every  ioo  grains  represent  354.13  grains  of  pure  crystallized 
sulphate,  or  i6y.yy  grains  of  anhydrous  chloride  of  zinc. 


POISONING    BY    BISMUTH.  305 

SECTION  II. 
POISONING  BY  BISMUTH. 

Subnitrate  of  Bismuth — Magistery  of  Bismuth — Pearl 
White. — This  substance  is  considerably  employed,  both  me- 
dicinally and  as  a  cosmetic.  As  a  medicine  it  is  given  in 
doses  of  five  to  thirty  grains.  Several  fatal  cases  have  been 
reported  as  resulting  from  large  doses;  the  symptoms  being 
those  of  a  violent  irritant  poison.  Many  authorities  ascribe 
these  results  to  the  adulteration  of  the  bismuth  with  arsenic. 
Dr.  Taylor  states  that  this  adulteration  is  very  common,  and 
that  he  detected  arsenic  in  comparatively  large  quantities  in 
three  out  of  five  specimens  obtained  from  respectable  Lon- 
don druggists.  The  arsenic  may  readily  be  discovered  by 
dissolving  the  subnitrate  in  pure  hydrochloric  acid,  slightly 
diluted,  and  employing  a  Marsh's  apparatus.  This  same 
adulteration  has  occasionally  been  found  in  the  subnitrate  of 
our  own  shops;  and  it  should  be  looked  to  by  physicians 
as  being  the  probable  cause  of  the  irritation  which  occa- 
sionally follows  the  use  of  this  medicine. 

This  impurity  may  essentially  modify  a  medico-legal 
opinion  as  to  the  presence  of  arsenic  in  a  body,  where  bis- 
muth had  been  previously  administered  medicinally.  A 
case  of  this  nature  (State  of  Virginia  vs.  Mrs.  E.  E.  Lloyd, 
1872)  occurred,  in  which  the  defence  contended  that  the 
trace  of  arsenic  alleged  to  have  been  discovered  in  the  liver 
of  the  deceased  was  to  be  ascribed  to  the  subnitrate  of  bis- 
muth which  had  been  taken  before  death.  This  bismuth 
was  found  to  be  contaminated  with  arsenic.  The  prisoner 
was  acquitted. 

By  the  process  recommended  by  the  present  U.  S.  Phar- 
macopoeia, the  bismuth  is  entirely  freed  from  arsenic. 

Subnitrate  of  bismuth  is  in  the   form  of  a  white  powder, 
14* 


306  TOXICOLOGY. 

insoluble  in  water,  but  soluble  in  nitric  acid.  The  solution, 
thrown  into  water,  yields  a  copious  white  precipitate,  which 
blackens  by  sulphide  of  ammonium,  and  is  not  soluble  in 
tartaric  acid. 

A  delicate  test  for  a  bismuthic  salt  is  a  piece  of  paper 
wetted  with  a  solution  of  sulphocyanide  of  potassium  and 
dried  ;  a  beautiful  yellow  spot  appearing  at  the  point  of  con- 
tact. It  is  stated  that  the  urine  will  reveal  the  presence  of 
bismuth,  a  few  hours  after  taking  the  subnitrate,  by  means 
of  this  test. 

SECTION  III. 
POISONING  BY  TIN,  IRON  AND  CHROMIUM. 

Salts  of  Tin. — The  only  preparations  of  tin  requiring  no- 
tice are  the  chlorides.  The  effects  of  these  salts  upon  the 
system  are  those  of  the  metallic  irritants ;  but  the  instances 
of  poisoning  by  them  are  rare. 

The  protochloride  is  precipitated  by  sulphuretted  hy- 
drogen of  a  dark  chocolate  color.  Corrosive  sublimate 
throws  down  the  gray  metallic  mercury.  Chloride  of  gold 
gives  a  fine  purple  precipitate — the  purple  of  Cassius.  A 
fragment  of  zinc  precipitates  metallic  tin,  in  an  arborescent 
form. 

Bichloride  of  tin  is  precipitated  yellow  by  sulphuretted 
hydrogen.  This  sulphide  is  distinguished  from  the  yellow 
sulphide  of  arsenic  by  being  insoluble  in  ammonia,  and 
from  sulphide  of  cadmium  by  being  insoluble  in  hydro- 
chloric acid.  Corrosive  sublimate  and  chloride  of  gold 
yield  no  precipitate  with  it. 

The  preparations  of  Silver,  Gold  and  Platinum  (with  its 
allied  metals)  are  all  highly  irritant  and  corrosive  ;  but  they 
so  rarely  are  the  occasion  of  poisoning  in  the  human  sub- 
ject, that  they  need  no  further  discussion  here. 


POISONING    BY   CHROMIUM.  307 

Preparations  of  Iron. — The  sulphate  (green  vitriol)  is 
highly  irritant  in  large  doses,  having  proved  fatal  in  several 
instances.  Its  action  resembles  that  of  sulphate  of  copper, 
though  less  violent. 

The  chloride,  in  the  form  of  tincture  (muriated  tincture 
of  iron),  is  much  used  in  medicine.  In  large  doses  it  acts 
as  a  violent,  corrosive  poison.  Christison  records  the  case 
of  a  man  who  swallowed,  by  mistake,  an  ounce  and  a  half 
of  the  liquid,  and  who  died  in  about  five  weeks.  It  is  oc- 
casionally used  as  an  abortive. 

Preparations  of  Chromium. — The  salts  of  chrome  most 
used  in  the  arts  are  the  chromate  and  bichromate  of  potassium, 
and  the  chromate  of  lead.  The  two  former  are  violent  irri- 
tants in  large  doses ;  sometimes  acting,  also,  as  corrosives 
to  the  lining  membrane  of  the  alimentary  canal. 

Bichromate  of  potassium  may  be  distinguished — (i)  by 
its  deep  orange-red  color;  (2)  by  solution  of  acetate  of  lead, 
which  precipitates  the  yellow  bichromate  of  lead  ;  (3)  by  ni- 
trate of  silver,  which  throws  down  a  deep  red  precipitate ; 

(4)  sulphuretted  hydrogen   gives  a   dingy-green   sulphide ; 

(5)  sulphuric  acid  added  to  a  solution,  along  with  alcohol, 
instantly  throws  down  the  green  oxide,  with  effervescence  ; 
yielding,  at  the  same  time,  the  odor  of  aldehyde. 


308  TOXICOLOGY. 


CHAPTER    XXIII. 

VEGETABLE  AND  ANIMAL  IRRITANTS. 

SECTION  I.— POISONING  BY  OXALIC  ACID. 

SOURCES  OF  THE  ACID  IN  NATURE. — SYMPTOMS. — FATAL  DOSE. — 
TREATMENT.  —  MORBID  APPEARANCES.  —  CHEMICAL  ANALYSIS.  — 
TOXICOLOGICAL   EXAMINATION. — BINOXALATE   OF   POTASSIUM. 

Oxalic  Acid,  in  combination  with  lime  and  potash,  exists 
naturally  in  certain  plants,  as  the  rhubarb,  wood-sorrel,  dock, 
etc.  It  is  extensi\Tely  used  in  the  arts,  under  the  name  of 
acid  of  sugar.  It  is  rarely  employed  for  homicidal  poi- 
soning, since  it  would  be  easily  detected  by  its  excessively 
sour  taste ;  but  it  is  sometimes  resorted  to  for  suicidal  pur- 
poses, and  it  has  been  frequently  the  cause  of  accidental 
death,  from  its  being  mistaken  for  sulphate  of  magnesia 
(Epsom  salt),  which  it  much  resembles  in  appearance. 

Symptoms. — These  depend  very  much  on  the  size  of  the 
dose  and  the  degree  of  concentration.  In  the  quantity  of 
half  an  ounce  to  an  ounce,  it  acts  as  a  prompt,  violent, 
corrosive  poison.  In  smaller  doses  and  more  diluted,  its 
irritant  effects  may  be  much  lessened,  or  altogether  lost ; 
but  its  remote,  specific  operation  on  the  heart  and  nerve 
centres  is  very  observable  in  the  acute  pain  in  the  back,  ex- 
tending down  the  limbs,  attended  with  tingling  and  numb- 
ness, and  with  tetanic  spasms,  together  with  occasional 
narcotism.     On  the  heart,  it  acts  as  a  decided  depressant. 

When  swallowed  in  a  very  large  dose  and  dissolved  in  a 
small  quantity  of  water,  the  effects  are  immediate.  An 
intensely  sour  taste  is  followed  by  a  burning  sensation  in 
the  gullet,  extending  down  to  the  stomach ;  violent  pain  in 


POISONING    BY    OXALIC    ACID.  309 

the  abdomen,  increased  by  pressure ;  constriction  of  the 
throat;  vomiting  of  a  greenish-brown  or  black  matter, 
sometimes  mixed  with  blood.  If  the  patient  lives,  purging 
of  a  similar  character  sets  in.  The  remaining  symptoms 
are  those  of  collapse,  such  as  extreme  debility,  a  cold, 
clammy  skin,  feeble,  rapid  pulse  and  hurried  respiration. 
There  are  also  soreness  of  the  mouth,  swelling  of  the 
tongue,  intense  thirst,  restlessness  and  distressing  cough  ; 
also,  frequently,  cramps  and  numbness  of  the  legs  and  arms, 
loss  of  voice,  acute  pain  in  the  back  and  head,  delirium  and 
convulsions — symptoms  that  indicate  the  action  of  the  poi- 
son on  the  nervous  system.  As  in  the  case  of  other  violent 
poisons,  the  above-mentioned  symptoms  are  liable  to  many 
exceptions  and  anomalies  ;  thus,  vomiting  and  pain  may 
both  be  absent. 

There  is  every  reason  to  believe  that  the  poison  is  ab- 
sorbed into  the  blood,  though  hitherto  experiments  have 
failed  to  detect  it  in  that  fluid.  Christison  mentions  a  case 
where  leeches,  that  had  been  applied  to  the  epigastrium  of  a 
patient  who  had  been  poisoned  by  this  acid,  fell  off  dead, 
showing  evidently  that  it  had  gotten  into  the  circulation. 
The  urine  contains  crystals  of  oxalate  of  lime  in  abundance, 
also  albumen  and  tube-casts ;  and  according  to  some 
writers,  deposits  of  similar  crystals  within  the  renal  tubules. 

Fatal  dose. — Half  an  ounce  to  an  ounce  is  regarded  as  a 
fatal  dose  for  an  adult.  Dr.  Taylor  quotes  a  case  where 
one  drachm  of  the  solid  crystals  proved  fatal  to  a  boy  six- 
teen years  old,  in  eight  hours.  There  are,  however,  cases 
on  record  where  much  larger  doses  have  been  swallowed 
without  causing  death. 

Fatal  period. — In  a  large,  concentrated  dose,  oxalic  acid 
is  one  of  the  most  energetic  poisons  known.  Christison 
calls  it "  the  most  rapid  and  unerring  of  all   the  common 


310  TOXICOLOGY. 

poisons."  Dr.  Ogilvie  reports  the  most  rapidly  fatal  case 
known,  where  death  occurred  in  three  minutes  after  swallow- 
ing it  (Lancet,  Aug.  1845).  In  other  cases,  death  has 
followed  in  ten  minutes ;  the  majority  of  cases  prove  fatal 
within  one  hour.  Again,  instances  have  occurred  where  the 
patient  has  survived  for  many  hours,  and  even  days.  Dr. 
Beck  alludes  to  the  case  of  a  woman  who  died  from  the 
secondary  effects  of  the  poison,  after  several  months  of 
suffering. 

Treatment. — This  should  be  prompt,  in  order  to  be  of  any 
service.  The  best  antidotes  are  chalk  and  magnesia,  mixed 
up  with  milk.  The  alkalies  and  their  carbonates  are  in- 
admissible, on  account  of  their  forming  soluble  poisonous 
compounds  with  the  acid.  The  scrapings  of  a  whitewashed 
wall  should  be  resorted  to  in  the  absence  of  chalk  and  mag- 
nesia. Lime-water  and  oil  are  useful.  Opium  is  indicated 
to  relieve  the  severity  of  the  symptoms. 

Post-mortem  appearances. — The  lining  membrane  of  the 
mouth,  throat  and  gullet  will  usually  be  found  white, 
shriveled  and  easy  of  removal ;  it  may  be  covered  over  with 
the  brown  matters  discharged  from  the  stomach.  The 
mucous  membrane  of  the  oesophagus  may  be  entirely 
separated,  displaying  a  surface  of  a  brown  color,  and  raised 
in  longitudinal  folds.  The  stomach,  which  is  frequently 
contracted,  contains  an  intensely  acid,  brown,  gelatinous 
fluid ;  the  mucous  membrane,  if  death  has  been  rapid,  may 
appear  soft  and  pale,  often  without  marks  of  decided  inflam- 
mation ;  but  if  death  has  been  delayed,  it  is  usually  black 
in  some  places,  and  in  others  intensely  congested  and  in 
rugse,  with  portions  peeling  off,  revealing  a  gangrenous  con- 
dition of  the  subjacent  tissue.  Such  cases  strongly  resemble 
those  of  sulphuric  acid  poisoning.  Perforation  of  the 
stomach  is  rare. 


OXALIC    ACID CHEMICAL    ANALYSIS.  311 

The  intestines  are  usually  highly  congested,  if  death  has 
been  at  all  delayed.  The  lungs  generally,  and  the  brain 
occasionally,  have  been  found  congested.  The  heart  is 
sometimes  quite  empty,  and  at  others,  distended  with  dark 
blood.  The  blood  throughout  the  body  is  fluid.  A  few- 
cases  have  occurred  where  all  morbid  appearances  have  been 
absent. 

Chemical  analysis. — (i)  As  a  solid.  When  pure,  it  occurs 
in  colorless  four-sided  crystals,  of  an  intensely  sour  taste 
(by  which  it  is  immediately  distinguished  from  sulphate  of 
magnesium),  being  soluble  in  water,  especially  hot ;  soluble, 
also,  in  alcohol,  but  insoluble  in  ether,  and  nearly  so  in 
chloroform.  It  is  completely  volatilized  by  heat,  leaving  no 
residue;  this  is  not  the  case  with  the  sulphates  of  magnesium 
and  zinc,  for  which  it  has  been  mistaken. 

(2)  As  a  liquid. — It  reddens  litmus  paper;  a  drop 
evaporated  to  dryness  leaves  long,  slender  prisms,  (a) 
Nitrate  of  silver  gives  a  copious  white  precipitate  of  oxalate 
of  silver,  distinguished  from  the  chloride  and  cyanide  by 
being  soluble  in  cold  nitric  acid.  If  the  precipitate  is  thor- 
oughly dried  and  heated  on  platinum  foil,  it  is  completely 
dissipated  in  a  white  vapor,  in  a  succession  of  puffs  or  slight 
detonations,  (I?)  Sulphate  of  calcium  (ox  any  lime  salt)  gives 
a  white  precipitate  of  oxalate  of  calcium,  which  is  distin- 
guished from  the  carbonate  and  phosphate  by  being  insoluble 
in  acetic  acid,  but  being  soluble  in  nitric,  and  rather  less  so 
in  hydrochloric  acid.  Sulphate  of  calcium  will  also  pre- 
cipitate solutions  of  barium,  strontium  and  lead;  but  the 
sulphates  of  these  bases  are  insoluble  in  nitric  acid,  (c) 
Chloride  of  barium,  nitrate  of  strontium  and  acetate  of  lead 
all  precipitate  the  white  crystalline  oxalates  of  these  bases, 
which  are  soluble  in  nitric  and  hydrochloric  acids  ;  but  these 
tests  are  of  inferior  value  to  the  former  ones,    (cl)  Sulphate 


312  TOXICOLOGY. 

of  copper  yields  a  faint  bluish-white  oxalate  of  copper, 
which  is  almost  insoluble  in  nitric  acid. 

Toxicological  examination. — If  the  contents  of  the  stomach 
are  highly  acid,  the  poison  may  probably  be  separated  by 
dialysis,  or  they  may  be  digested  with  distilled  water,  at 
a  moderate  heat,  for  some  hours,  and  then  filtered,  the 
filtrate  concentrated,  and  tested  with  sulphate  of  copper. 
If  this  test  affords  evidence  of  the  presence  of  oxalic  acid, 
the  liquid  may  be  evaporated  to  crystallization,  and  the 
crystals  thus  obtained  re-dissolved  in  pure  alcohol,  and  the 
solution  again  crystallized. 

But  it  is  usually  recommended  to  treat  the  first  filtrate 
with  an  excess  of  solution  of  acetate  of  lead ;  wash  the 
precipitated  oxalate  of  lead  on  the  filter;  then  diffuse  it 
thoroughly  in  pure  water  and  pass  through  it  a  current  of 
washed  sulphuretted  hydrogen,  until  all  the  lead  and  organic 
matter  is  thrown  down.  Heat  a  little  while,  to  expel  the 
excess  of  sulphuretted  hydrogen,  then  filter,  and  crystallize 
the  filtrate  by  evaporation.  Purify  the  crystals,  if  necessary, 
by  re-solution,  and  apply  the  usual  tests. 

But  it  may  happen  that  all  the  oxalic  acid  in  the  stomach 
has  been  neutralized  by  the  antidotes  that  were  adminis- 
tered— lime  or  magnesia,  in  which  case  the  contents  of  the 
stomach  would  not  be  acid.  Here  the  inspected  solids 
should  be  collected,  and  thoroughly  washed  with  warm 
water,  and  the  liquid  decanted  off;  if  this  liquid  is  acid,  it 
should  be  reserved  for  examination ;  if  not  acid,  it  may  be 
thrown  away.  The  solids  should  then  be  diffused  in  pure 
wrater,  and  boiled  for  some  time  with  pure  carbonate  of 
potassium,  which  decomposes  the  oxalates,  forming  soluble 
oxalate  of  potassium  and  insoluble  carbonate  of  lime  and 
magnesia.  These  are  separated  by  filtration,  and  the  solution 
concentrated  by  gentle  heat,  until  the  crystals  arc  formed. 


OXALIC    ACID DETECTION.  313 

In  a  case  of  alleged  oxalic  acid  poisoning,  it  might  be 
objected  that  the  presence  of  a  minute  quantity  of  oxalic 
acid  found  in  the  stomach  after  death  might  be  due  to  rhu- 
barb or  sorrel  that  had  been  eaten  by  the  deceased.  The 
answer  to  this  is  obvious:  if  there  is  an  entire  absence  of  all 
the  characteristic  symptoms  of  this  active  poison,  the  dis- 
covery of  a  small  quantity  of  the  acid  is  certainly  no  evi- 
dence of  poisoning;  but  on  the  other  hand,  if  the  peculiar 
symptoms  of  this  poison,  and  morbid  lesions  are  present, 
then  the  obtaining  of  only  a  small  amount  of  the  acid 
should  not  negative  the  charge  of  poisoning. 

In  a  case  of  suspected  poisoning  by  oxalic  acid,  the  urine 
should  always  be  examined  for  an  increase  of  the  octahe- 
dral crystals  of  oxalate  of  lime.  This  fluid  should  be  col- 
lected in  a  conical  glass,  and  the  sediment  which  collects 
after  some  time  should  be  examined  with  the  microscope. 
But  all  the  lime-oxalates  may  not  be  thus  precipitated ;  a 
portion  may  be  held  in  solution  by  the  acid  phosphate  of 
sodium  which  exists  in  the  urine. 

It  should,  however,  be  remembered  that  these  same 
crystals  may  be  found  in  the  urine  of  persons  who  have 
partaken  of  food  containing  oxalic  acid,  such  as  rhubarb 
and  sorrel. 

To  detect  free  oxalic  acid  or  a  soluble  oxalate  in  the 
urine,  add  a  little  acetic  acid  and  concentrate  to  about  one- 
fourth  its  bulk,  then  add  acetate  of  lead  in  excess,  filter  ; 
decompose  the  oxalate  of  lead  with  sulphuretted  hydrogen, 
and  treat  the  filtered  solution  as  above  directed. 

Stains  of  this  acid  on  cloth,  parchment,  paper,  etc.,  may 
be  discovered  by  boiling  them  in  water,  and  applying  the 
usual  tests.  The  color  of  these  stains  on  black  cloth  is 
orange,  and  brownish-red.  This  acid  is  sometimes  employed 
to  remove  writing-ink,  in  cases  of  forgery  ;  but  usually  there 


314  TOXICOLOGY. 

are  left  on  the  paper  traces  of  iron,  existing  in  the  ink,  which 
can  readily  be  recognized  by  applying  a  solution  of  the  fer- 
rocyanide  of  potassium,  which  will  turn  it  blue. 

Oxalic  acid  is  usually  estimated  quantitatively  as  oxalate 
of  lead;  every  ioo  parts  of  the  dried  pure  oxalate  are 
equivalent  to  42.5  of  the  crystallized  acid. 

Oxalic  acid  is  not  a  normal  constituent  of  the  human 
body;  although  supposed  by  Liebig  and  others  to  be  one 
of  the  ultimate  results  of  the  oxidation  of  uric  acid  in  the 
economy,  yet  no  one  has  been  able  to  demonstrate  its 
existence  in  the  blood.  In  disease  it  is  frequently  found  in 
the  tissue  in  the  form  of  oxalate  of  lime,  in  which  form  also 
it  constitutes  the  variety  of  calculus  named  the  mulberry 
calculus. 

Binoxalate  of  Potassium — {Salt  of  Sorrel — Essential  Salt 
of  Lemons}. — This  salt  is  much  used  in  the  arts  for  bleach- 
ing, etc.  It  is  almost  as  active  a  poison  as  oxalic  acid.  The 
symptoms,  dose  and  lesions  are  very  similar  to  those  of  the 
acid.  It  is  distinguished  from  the  latter,  (1)  by  heating  a 
fragment  on  platinum  foil;  an  ash  is  left  (carbonate  of  po- 
tassium), while  the  acid  is  entirely  dissipated ;  (2)  it  crys- 
tallizes in  feathery  forms  ;  (3)  it  is  distinguished  from  cream 
of  tartar  by  lime  water,  which  precipitates  both,  but  the 
tartrate  of  calcium  is  immediately  re-dissolved  by  tartaric 
acid,  while  the  oxalate  is  insoluble.  This  salt  is  a  natural 
ingredient  in  the  sorrel. 

Tartaric  and  acetic  acids  act  as  powerful  irritant  poisons 
in  the  concentrated  state  and  in  large  doses.  They  have 
both  produced  fatal  results  when  taken  in  doses  of  an 
ounce.  Their  proper  antidotes  are  the  alkaline  carbonates, 
and  chalk  or  magnesia. 


POISONING    BY    CARBOLIC   ACID.  315 

SECTION  II. 
POISONING   BY  CARBOLIC  ACID. 

Carbolic  Acid — (Phenic  Acid — Phenol} — is  one  of  the 
products  of  the  distillation  of  coal  tar.  When  pure  it  is  in 
the  form  of  white  acicular  crystals,  which,  when  exposed 
for  some  time  to  the  light,  acquire  a  reddish  tinge.  They 
have  a  strong  affinity  for  water,  and  liquefy  when  exposed 
to  the  air.  It  is  not,  however,  very  soluble  in  water;  much 
more  so  in  alcohol,  ether  and  glycerine.  It  has  a  burning 
taste,  and  a  peculiar,  strong,  creasote  odor.  It  is  sometimes 
named  coal-tar  creasote.  It  is  powerfully  antiseptic,  quickly 
destroying  the  germs  of  the  lower  forms  of  organic  life. 
Applied  in  its  undiluted  state  to  the  skin,  it  acts  as  a  cor- 
rosive and  anaesthetic,  corrugating  and  hardening  it.  Taken 
internally,  undiluted,  its  effects  are  those  of  an  energetic, 
corrosive  and  neurotic  poison. 

Symptoms. — Intense  burning  pain  in  the  mouth,  throat 
and  stomach;  the  pupils  are  contracted;  the  conjunctiva 
insensible  to  the  touch  ;  marked  odor  of  the  acid  exhaled 
from  the  breath  ;  the  skin  cold  and  clammy ;  the  tempera- 
ture rapidly  falls ;  the  pulse  becomes  weaker  and  weaker, 
but  fluctuates  in  its  beats ;  respiration  is  labored  and  ulti- 
mately stertorous  ;  vomiting  of  a  frothy  mucus  sometimes 
occurs ;  the  mouth  is  white,  and  hardened,  from  the  local 
effects  of  the  acid.  Coma  usually  precedes  death,  which 
may  also  sometimes  be  accompanied  by  convulsions.  Death 
may  occur  within  an  hour  from  swallowing  the  poison  ;  in 
one  case,  within  ten  minutes.  The  urine,  as  shown  by 
Stevenson,  is  often  of  an  olive-green  color. 

Many  of  the  above  symptoms  have  been  produced  by 
the  external  application  of  the  acid,  especially  to  denuded 
surfaces. 


316  TOXICOLOGY. 

Fatal  dose. — Dangerous  symptoms  have  occurred  from 
doses  of  six  or  seven  drops.  The  deaths  recorded  have 
resulted  from  doses  of  one  to  two  ounces ;  but  much  less 
quantity  would  certainly  prove  fatal. 

Treatment. — Assist  the  evacuation  of  the  poison  by 
emetics  of  mustard  water,  and  sulphate  of  zinc,  albumen, 
oil  and  demulcents.  Sulphate  of  soda  is  regarded  by  some 
as  a  true  antidote.  Dr.  Husemann  considers  the  saccharate 
of  lime  an  antidote.  Oil  is  the  best  outward  application  to 
the  skin.  Stimulants  must  be  freely  given,  to  combat  the 
collapse. 

Post-mortem  lesions. — The  mouth  and  oesophagus  are 
usually  white,  soft  and  corroded,  but  sometimes  har- 
dened and  corrugated.  The  brain  is  generally  normal,  but 
occasionally  congested,  and  the  fluid  in  the  ventricles  exhal- 
ing the  strong  odor  of  the  acid.  The  lungs  are  usually 
gorged  with  blood.  The  left  ventricle  of  the  heart  is 
generally  contracted,  while  the  right  is  flaccid.  The  blood 
is  uniformly  dark  colored  and  fluid.  The  odor  of  car- 
bolic acid  is  detected  in  the  stomach,  sometimes  in  the 
intestines,  and  even  in  the  other  viscera.  The  mucous  lin- 
ing of  the  stomach  has  been  found  white,  hardened  and 
wrinkled  ;  but,  again,  highly  congested  and  corroded.  The 
bladder  is  usually  empty,  any  urine  passed  being  of  a  dark, 
or  olive-green  color. 

Chemical  analysis. — The  odor  is  probably  the  best  test. 
It  has  a  slight  acid  reaction,  and  forms  salts  with  bases.  It 
imparts  a  transient,  greasy  stain  to  paper.  It  coagulates 
albumen.  It  gives  a  deep  violet  color  to  perchloride  of 
iron,  and  a  bluish  tint  to  ammonia  and  hypochlorite  of  lime; 
if  this  be  acidulated,  it  turns  red.  Bromine  water  causes  a 
whitish-yellow  flocculent  precipitate;  if  this  be  treated  with 
sodium-amalgam,  carbolic  acid  is  set  free  (Landolt).    Heated 


POISONING    BY    CROTON    OIL.  317 

with  cyanide  of  potassium,  it  gives  a  red  tint.  A  splinter 
of  wood,  moistened  with  the  acid,  and  afterward  dipped  into 
nitric  or  hydrochloric  acid,  turns  of  a  greenish-blue  tint 
when  dry  (Woodman  and  Tidy). 

Toxicological  examination. — Generally,  the  characteristic 
odor  of  the  acid  will  be  perceived  in  the  body  after  death. 
The  organic  matters  should  be  distilled  along  with  dilute 
sulphuric  acid. 

Carbolic  acid  can  generally  be  detected  in  the  urine,  both 
by  the  odor  and  by  chemical  reagents.  The  urine  may 
either  be  distilled  without  sulphuric  acid  (as  it  is  said  this 
acid  may  develop  carbolic  acid  from  some  of  the  normal 
constituents  of  the  urine);  or  by  agitating  it  with  an  excess 
of  ether,  and  subsequently  removing  the  ethereal  layer  by 
means  of  a  pipette,  and  evaporating  in  a  shallow  dish ;  a 
minute  oily  residue  is  left,  having  the  character  of  carbolic 
acid. 

SECTION  III. 

POISONING  BY  CROTON  OIL,  ELATERIUM,  CASTOR-OIL  BEANS, 
COLCHICUM,  AND  SAVIN. 

Croton  oil  is  a  fixed  oil,  extracted  by  pressure  from  the 
seeds  of  Croton  tiglium.  It  is  used  in  medicine  as  a  powerful 
purgative,  in  doses  of  one  or  two  drops.  In  over-doses,  it  acts 
as  a  violent  irritant  to  the  gastro-intestinal  mucous  mem- 
brane, causes  excessive  vomiting  and  purging,  followed  by 
collapse,  as  in  cholera.  Its  poisonous  properties  seem  to  be 
dependent  on  a  peculiar  fatty  acid  named  crotonic,  which 
exists  in  the  oil  in  variable  quantities.  When  deprived  of 
this  acid  the  oil  is  harmless. 

Croton  oil  is  of  a  light  yellow  color,  has  an  unpleasant 
odor,  and  a  hot,  acrid,  burning  taste.  It  is  very  soluble  in 
ether.  Nitric  acid,  with  the  aid  of  heat,  imparts  to  it  a  dark 
brown  color. 


318  TOXICOLOGY. 

Death  has  resulted  in  one  case  from  taking,  by  mistake, 
an  embrocation  containing  thirty  minims  of  the  oil.  In 
another  case,  two  and  a  half  drachms  proved  fatal  in  four 
hours;  whilst  in  a  third  instance,  half  an  ounce  of  croton  oil 
was  taken  by  mistake,  and  after  exciting  violent  vomiting 
and  purging,  with  symptoms  of  collapse,  the  patient  re- 
covered, after  fourteen  days. 

Analysis. — Separate  the  oil  from  the  contents  of  the 
stomach  by  means  of  ether,  and  evaporate  the  ethereal  solu- 
tion spontaneously,  and  test  the  resulting  oil  with  nitric 
acid  and  heat. 

Elatcrium. — This  substance  is  procured  from  the  juice  of 
Ecbalium  officinarum,  or  squirting  or  wild  cucumber.  It  is 
used  in  medicine  as  a  powerful  drastic  purgative.  Its  effects 
are  very  similar  to  those  of  croton  oil.  One  grain  of  good 
elaterium  has  produced  very  violent  effects.  It  owes  its 
activity  to  a  neutral  resinous  principle,  elaterin.  Nitric 
acid  has  no  action  upon  it.  Sulphuric  acid  turns  it  of  a 
reddish-brown  color. 

Castor  Oil  Beans  are  derived  from  the  Ricinus  communis, 
and  yield  by  pressure  the  castor  oil  of  commerce.  The 
seeds  contain  an  irritant,  poisonous  principle,  which  causes 
them  to  act  violently  when  swallowed.  They  have  occa- 
sionally proved  fatal.  In  one  case  three  seeds  destroyed 
life  in  an  adult  male  in  forty-six  hours,  and  twenty  seeds 
proved  fatal  to  a  young  lady  in  five  days,  after  violent 
symptoms,  strongly  resembling  those  of  malignant  cholera. 

ColcJiicum. — The  Colchicum  autnmnale,  or  meadow  saffron, 
contains  a  powerful  alkaloidal  principle,  colchicina,  which 
strongly  resembles  veratria  in   many  of  its  properties.     It 


POISONING    BY    COLCHICUM.  319 

abounds  chiefly  in  the  bulb  of  the  plant,  but  is  also  found  in 
the  seeds. 

The  effects  of  a  large  dose  upon  the  system  are  those  of  a 
v.'olent  irritant,  such  as  burning  pain  in  the  throat  and 
stomach,  great  thirst,  vomiting  and  soreness,  purging, 
cramps,  cold,  collapsed  skin,  feeble  pulse,  dilated  pupils, 
suppression  of  urine,  and  rapid  exhaustion.  Sometimes 
there  are  delirium  and  convulsions. 

The  strength  of  the  preparations  of  colchicum  varies 
greatly,  depending  upon  the  time  of  gathering  the  plant,  and 
also  its  place  of  growth. 

Death  has  resulted  in  seven  hours,  and  again  has  been 
delayed  for  several  days.  Generally,  it  occurs  within 
twenty- four  hours.  Less  than  half  an  ounce  of  the  wine  of 
the  root,  forty-eight  grains  of  the  dried  bulb,  and  a  table- 
spoonful  of  the  seeds  have  severally  proved  fatal.  A  fright- 
ful accident  occurred  in  Montreal,  Canada,  in  1873,  to  a 
company  of  eight  or  nine  persons.  They  had  freely  par- 
taken of  what  they  supposed  to  be  ordinary  wine,  but 
which  was  really  wine  of  colchicum.  In  the  course  of  a 
few  hours  they  became  alarmingly  ill,  with  nausea,  vomit- 
ing, excruciating  pains,  purging,  cramps  and  prostration. 
Five  of  the  cases  terminated  fatally  within  thirty-six  hours. 

Morbid  appearances. — These  consist  of  inflammation  of 
the  stomach  and  bowels.  In  some  instances,  no  morbid 
appearances  exist.  In  one  case,  the  pia  mater  was  much 
congested,  when  there  was  an  absence  of  inflammation  from 
the  stomach.     The  lungs  are  usually  deeply  congested. 

Colchicine/,  occurs  in  fine,  white  crystals.  It  is  soluble  in 
water,  has  a  feeble,  alkaline  reaction,  and  a  bitter,  acrid  taste. 
Its  best  test  is  nitric  acid,  which  gives  it  a  violet  color, 
changing  to  blue  and  brown.  It  differs  from  veratria  in  its 
negative  action  with  sulphuric  acid.     It  may  be  recovered 


320  TOXICOLOGY. 

from  organic  mixtures  by  a  modification  of  Staas'  process 
{vid.  post)  Less  than  half  a  grain  of  colchicina  has 
proved  fatal.     There  is  no  known  antidote  to  it. 

Savin. — The  tops  of  the  Juniperus  sabina  contain  a  vola- 
tile yellow  oil  (oil  of  savin),  which  may  be  procured  by  dis- 
tillation. Both  powder  and  oil  are  employed  in  medicine, 
and  both  possess  powerfully  irritant  properties.  They  are 
seldom  or  never  used  as  poisons,  but  they  frequently  produce 
fatal  results  when  used  as  abortives.  Although  they  do  not 
possess  specific  ecbolic  properties,  uterine  contractions  may 
follow  their  powerful  irritant  effects  upon  the  pelvic  viscera ; 
but  death  is  a  more  frequent  result,  without  the  expulsion  of 
the  foetus. 

In  cases  of  poisoning  by  the  powder,  this  may  often  be 
discovered  in  the  stomach  and  bowels,  by  microscopic  in- 
spection. The  oil  maybe  separated  by  distillation  from  the 
contents  of  the  stomach,  and  then  agitating  the  distillate 
with  ether,  in  which  it  is  soluble,  and  allowing  the  solution 
to  evaporate.  It  is  recognized  by  its  peculiar  terebinthinate 
odor. 

SECTION    IV. 

POISONING  BY  THE  HELLEBORES. 

VERATRIA — YELLOW   JESSAMINE — POISONOUS   MUSHROOMS. 

Black  Hellebore — (Helleborus  niger) — formerly  named 
Melampodium,  is  sometimes  employed  in  medicine.  It  is  a 
powerful  irritant  to  the  stomach  and  bowels,  and  has  proved 
fatal  in  overdoses,  occasioning  violent  vomiting,  purging, 
abdominal  pain,  cold  sweats,  collapse  and  convulsions. 

Green  Hellebore  ( Veratrum  viride — American  Hellebore — 
Indian  Poke). — This  species  possesses  very  active  properties, 
and  has  occasioned  fatal  results.  The  tincture  is  used  in 
medicine  as  a   powerful    cardiac    depressant.     Two   active 


VERATRIA — TESTS.  32  1 

alkaloidal  principles  exist  in  this  drug — veratroidia  and 
viridia — which,  though  resembling  veratria  in  some  points, 
are  distinct  from  it. 

Wliite  Hellebore  ( Veratrum  album). — This  is  the  most  poi- 
sonous of  all  the  hellebores.  The  powder  produces  violent 
sneezing.  Taken  internally,  it  causes  a  sense  of  burning 
heat  and  constriction  of  the  throat,  great  anxiety,  nausea, 
vomiting  and  purging,  pain  of  the  abdomen,  trembling  of 
the  limbs,  great  prostration,  cold  sweats,  very  feeble  pulse, 
giddiness,  convulsions,  insensibility  and  death.  Death  has 
occurred  in  three  and  six  hours  after  taking  it. 

The  active  principle  is  Veratria,  which  also  exists  in  the 
Veratrum  sabadilla. 

Veratria. — As  found  in  the  shops,  this  alkaloid  is  in  the 
form  of  a  white  powder.  It  may  be  crystallized  with  diffi- 
culty. It  has  an  acrid,  bitter  taste,  followed  by  a  sense  of 
dryness  in  the  throat.  It  is  a  violent  irritant  to  the  nostrils, 
causing  excessive  sneezing.  It  is  insoluble  in  water,  soluble 
in  alcohol,  ether,  chloroform,  benzole  and  amylic  alcohol. 
Heated  on  porcelain,  it  melts  and  blackens,  evolving  a  pun- 
gent vapor. 

Effects. — Dr.  Taylor  (On  Poisons,  p.  510)  mentions  the 
case  of  a  lady  on  whom  the  A  of  a  grain  occasioned  most 
alarming  symptoms,  such  as  insensibility,  cold  sweats,  fail- 
ing pulse  and  collapse.  It  acts  as  a  local  irritant  to  the 
stomach  and  bowels,  and  at  the  same  time  as  a  general  de- 
pressant. 

Chemical  analysis. — The  characteristic  test  is  sulphuric 
acid.  A  drop  applied  to  the  pure  alkaloid  imparts  a  yellow 
color  to  it,  followed  by  a  reddish  tint,  which  gradually  passes 
to  a  deep  crimson.  This  change  is  brought  about  imme- 
diately by  heat.  Even  a  very  dilute  acid  causes  this  re- 
action, by  evaporating  to  dryness.  (See  Sulphuric  Acin, 
15 


:v>> 


TOXICOLOGY. 


ante?)  According  to  Wormley,  the  ioooo  of  a  grain  of  ve- 
ratria  may  be  thus  detected. 

Other  substances  give  a  red  color  to  sulphuric  acid — such 
as  solanine,  nareeiue,  salicine,  piperine,  etc.,  but  these  are 
immediately  colored  by  cold  sulphuric  acid,  whereas  veratria 
requires  the  lapse  of  some  time  before  this  change  is 
effected. 

Trapp's  test  consists  in  warming  the  colorless  solution  of 
veratria  in  concentrated  hydrochloric  acid,  when  a  persistent 
dark  red  color  results. 

/;/  organic  mixtures,  veratria  may  be  separated  by  a  modi- 
fication of  Stass'  process,  and  the  ultimate  chloroform  extract 
tested  by  sulphuric  acid.  Dr.  Wormley  states  that  by  this 
test  he  was  enabled  to  recognize  the  presence  of  veratria  in 
an  ounce  of  blood  of  a  cat  which  had  been  killed,  in  less 
than  one  minute,  by  two  grains  of  veratria. 

Yellow  Jessamine  (Gelsemium  sempervirens). — The  root 
of  this  plant  is  considerably  employed  in  medicine,  especially 
in  the  Southern  States  of  our  country,  in  the  treatment  of 
neuralgia,  and  analogous  complaints.  It  has  frequently 
produced  fatal  results,  the  symptoms  somewhat  resembling 
those  produced  by  veratria.  Wormley  found  it  to  contain 
a  powerful  alkaloidal  principle — gelsemia,  one-eighth  of  a 
grain  of  which  killed  a  rabbit  in  an  hour  and  a  half,  together 
with  another  organic  principle — gelseminic  acid.  The  above 
authority  succeeded  in  detecting  both  of  these  principles  in 
the  stomach  of  a  woman  who  was  poisoned  by  three  tea- 
spoonfuls  of  the  extract,  several  months  after  death  (Am. 
Jour.  Med.  Sci.,  April,  1870). 

Poisonous  Mushrooms. — As  is  well  known,  certain  varie- 
ties of  fungi  are  edible,  while  others  possess  noxious,  and 


POISONOUS    MUSHROOMS.  323 

even  fatal  properties.  It  is  not  always  possible  to  distin- 
guish between  these,  inasmuch  as  climate,  season,  and 
idiosyncracy  may  occasion  the  difference.  The  poisonous 
principle  of  certain  fungi  appears  to  be  volatile,  since  boiling 
renders  them  innocuous. 

Symptoms. — The  effects  of  poisonous  mushrooms  on  man 
are  those  of  the  narcotic  irritants,  causing  violent  vomiting, 
purging,  abdominal  pain,  thirst,  anxiety,  cold  sweats, 
together  with  giddiness,  dimness  of  vision,  trembling, 
dilated  pupils,  delirium,  illusions,  stupor,  coma,  convulsions 
and  death. 

It  is  stated  that  the  very  same  fungi  have  acted  on  some 
members  of  a  family  as  vomitants  only,  and  on  others  as 
narcotics. 

Generally,  the  symptoms  show  themselves  within  one 
hour — especially  the  narcotic  symptoms.  Orfila  (Toxicol. 
II,  p.  433)  relates  the  following  interesting  case  of  poisoning 
of  a  family  of  six  persons  by  the  Amanita  citrina.  The 
wife,  servant  and  one  of  the  children  had  vomiting,  followed 
by  deep  stupor,  but  they  recovered.  The  husband  had 
violent  cholera  ;  he  recovered  also.  The  two  other  children 
became  profoundly  lethargic  and  comatose ;  emetics  had  no 
effect,  and  death  ensued.  The  individuals  who  recovered 
were  not  completely  well  until  three  weeks  after  the  fatal 
repast. 

Morbid  appearances. — These  are  imperfectly  described ; 
they  indicate  a  great  tendency  to  rapid  putrefaction,  lividity 
of  the  body,  fluidity  of  the  blood,  absence  of  cadaveric 
rigidity,  numerous  ecchymoses  in  the  serous  membranes 
and  parenchymatous  organs,  signs  of  violent  and  even 
gangrenous  inflammation  of  the  stomach,  and  congestion 
of  the  vessels  of  the  brain,  with  decomposition  of  the 
tissues. 


324  .  TOXICOLOGY. 

The  chief  medico-legal  interest  connected  with  this  sub- 
ject is  the  fact  that  the  symptoms  occasioned  by  eating  poi- 
sonous fungi  might  easily  be  attributed  to  poisoning — 
homicidal,  or  otherwise.  A  microscopic  examination  of  the 
contents  of  the  stomach  and  bowels  will  usually  reveal  the 
botanical  character  of  the  fragments  of  the  fungi,  if  the  poi- 
soning has  been  due  to  them.  (See  Orfila  and  Christison 
on  the  subject  of  Poisonous  Fungi) 


POISONING    BY    CANTHARIDES — SYMPTOMS.  325 


CHAPTER   XXIV. 

ANIMAL  IRRITANTS. 

POISONING  BY  CANTHARIDES. — POISONOUS  ANIMAL  FOOD. — SAUSAGE 
POISON.  —  TRICHINOSIS. — CHEESE  POISON.  —  POISONOUS  FISH. — 
PUTRESCENT   FOOD.— POISONED   FLESH. 

Cantharides. — The  Cantharis  vesicatoria,  or  Spanish  fly, 
is  much  used  in  medicine,  both  externally  as  a  vesicant,  and 
also  internally.  In  large  doses  it  acts  as  a  powerful  local 
irritant  to  the  alimentary  canal,  and  also  to  the  urino- 
genital  organs.  It  is  often  used  as  an  abortive,  and  has  not 
unfrequently  produced  fatal  effects  when  employed  for  this 
purpose.  It  owes  its  active  properties  to  a  crystalline  prin- 
ciple named  canlJiaridin,  which  exists  in  the  proportion  of 
about  one  grain  to  half  an  ounce  of  the  powder. 

Symptoms. — A  burning  sensation  in  the  mouth  and  throat, 
with  constriction  and  difficulty  of  swallowing ;  violent  pain 
in  the  abdomen,  increased  by  pressure ;  nausea  and  vomit- 
ing of  a  bloody  mucus  and  shreds  of  membrane,  along  with 
great  thirst,  and  dryness  of  the  fauces.  Soon  the  charac- 
teristic impression  on  the  genito-urinary  organs  displays 
itself,  in  a  dull,  heavy  pain  in  the  loins,  an  urgent  and  inces- 
sant desire  to  urinate,  which  is  attended  with  great  pain  and 
the  voiding  of  merely  a  few  drops  of  bloody  urine,  accom- 
panied with  tenesmus.  Priapism  frequently  occurs  in  males, 
and  swelling  and  heat  of  the  labia  in  women,  together  with 
abortion,  at  times,  in  pregnant  females.  Purging  generally 
supervenes,  the  stools  being  bloody  and  mucous,  and  accom- 
panied with  tenesmus.  Sometimes  there  is  profuse  saliva- 
tion, and  in  fatal  cases  faintness,  giddiness,  and  convulsions. 


3-6  TOXICOLOGY. 

If  the  substance  has  been  taken  in  the  form  of  powder,  the 
characteristic  shining  green  particles  may  generally  be 
recognized  in  the  discharges  from  the  stomach  and  bowels. 
If  the  tincture  has  been  taken,  the  above  symptoms  come  on 
more  rapidly. 

All  the  above  symptoms  have  been  produced  by  the  ex- 
ternal application  of  cantharides. 

Fatal  dose. — Twenty-four  grains  of  the  powder,  and  an 
ounce  of  the  tincture,  have  caused  death. 

Treatment. — Speedy  evacuation  by  emetics  and  cathartics 
(castor  oil) ;  opium  and  stimulants. 

Post-mortem  appearances. — Intense  inflammation  of  the 
mucous  membrane  of  the  alimentary  canal,  from  the  mouth 
downward;  also  of  the  ureters,  kidneys  and  bladder.  Con- 
gestion of  the  brain  has  been  observed.  The  peculiar  shin- 
ing green  particles  can  generally  be  distinguished  in  the 
stomach  and  bowels.  But  if  the  tincture  has  been  swallowed 
it  will  be  necessary  to  procure  the  extraction  of  cantliaridin 
from  the  organic  matters. 

Cliemical  analysis. — The  suspected  materials  should  be 
dried,  and  digested  in  successive  portions  of  ether,  until  ex- 
hausted ;  this  will  dissolve  out  the  cantharidin.  The  ethereal 
solution  is  to  be  evaporated  until  nearly  dry,  and  the  residue 
should  be  spread  on  oiled  silk,  and  a  portion  applied  to  the 
lips,  or  on  the  thin  portion  of  the  skin  of  the  arm,  when  the 
resulting  vesication  would  denote  the  presence  of  can- 
tharides. 

Poisonous  animal  food. — It  occasionally  happens  that 
various  kinds  of  animal  food,  such  as  sausages,  cheese, 
fish,  mussels,  etc.,  produce  poisonous  symptoms,  either  ow- 
ing to  some  idiosyncrasy  on  the  part  of  those  who  have 
partaken  of  them,  or  depending  upon  some  noxious  agent 


SAUSAGE   AND    CHEESE   POISONING.  327 

connected  with  the  food  itself,  either  introduced  from  with- 
out, or  spontaneously  generated  within. 

Such  cases  are  often  attended  with  symptoms  of  a  violent 
character,  which  naturally  suggest  poisoning,  and  they  then 
become  the  subjects  of  medico-legal  examination  (vid.  post., 
Ptomaines). 

Sausage  poison. — It  was  formerly  supposed  that,  under 
certain  peculiar  circumstances,  not  well  understood,  sausages 
when  cured  and  dried  were  capable  of  developing  a  poison- 
ous principle,  in  the  shape  of  a  peculiar  fatty  acid,  named 
by  Bushner  batrolinic  acid.  But  physicians  and  physiolo- 
gists of  the  present  day  are  disposed  to  attribute  the  cause 
of  the  so-called  sausage-poison  to  the  presence  of  an  ento- 
zoon,  named  Trichina  spiralis,  which  especially  infests'  the 
muscles  of  the  hog,  and  which,  when  the  pork  is  eaten 
uncooked,  and  unless  it  has  been  exposed  for  some  time  to 
a  temperature  above  21 2°  F.,  very  soon  penetrates  the  mus- 
cular coat  of  the  intestines,  and  thence  spreads  rapidly 
through  the  muscles  generally,  and  which  increase  in 
numbers  prodigiously.  The  sudden  liberation  of  a  multi- 
tude of  these  parasites  from  their  cysts,  in  the  intestines  and 
muscles,  produces  the  irritation  of  the  bowels,  and  the  sub- 
sequent loss  of  muscular  power  that  are  so  characteristic 
of  tricliinosis. 

It  may  readily  happen  that  the  symptoms  thus  occasioned 
might  be  attributed  to  slow  poisoning  by  one  of  the  mineral 
irritants.  A  careful  microscopic  examination  of  the  sus- 
pected food,  or  of  a  fragment  of  a  muscle  of  either  a  living 
or  dead  subject,  will  reveal  the  true  source  of  the  disorder. 

The  symptoms  of  Cheese  poisoning  arc  very  similar  to 
those  of  ordinary  irritant    poisoning.     The    cause    of  the 


328  TOXICOLOGY. 

development  of  poisonous  properties  in  cheese  is  by  no 
means  well  understood.  By  some  it  is  ascribed  to  the  pro- 
duction of  an  acrid,  oily  matter  derived  from  an  improper 
fermentation  of  the  milk,  analogous  to  caseic  and  sebacic 
acid.  Instances  of  cheese  poisoning  are  more  common  in 
Germany  than  in  this  country. 

Poisonous  fish. — In  certain  individuals,  probably  through 
idiosyncrasy,  many  kinds  of  fish  act  poisonously,  i.  e.t  they 
excite  severe  gastro-intestinal  symptoms,  resembling  cholera 
morbus.  It  is  quite  possible  that  some  peculiar  organic 
change  in  the  food  itself  may  have  taken  place.  Mussels, 
which  are  quite  extensively  used  in  Europe  as  food,  occa- 
sionally produce  most  violent  and  alarming  symptoms, 
which  cannot  be  ascribed  to  any  rational  cause. 

These  symptoms  are  not  of  a  uniform  character.  Some- 
times they  are  those  of  a  simple  irritant,  such  as  nausea, 
vomiting,  purging,  pain  in  the  abdomen,  cramps,  small  and 
frequent  pulse.  The  fatal  cases  disclose,  on  post-mortem 
examination,  evident  signs  of  inflammation.  In  other 
instances,  the  gastro-enteric  disturbance  has  been  slight, 
whilst  the  nervous  symptoms  are  well  marked,  such  as 
delirium,  insensibility  and  coma,  with  dyspnoea  and  convul- 
sions. Again,  the  most  conspicuous  symptoms  have  been 
a  peculiar  eruption  resembling  urticaria,  along  with  severe 
asthma.  The  symptoms  usually  do  not  appear  until  the  lapse 
of  twenty-four  hours,  but  there  are  cases  where  they  come  on 
very  much  earlier.  In  fatal  cases,  the  autopsy  usually  reveals 
nothing  that  will  satisfactorily  account  for  the  result. 

No  rational,  adequate  cause  of  this  singular  poisonous 
action  of  the  shell  fish  has  yet  been  discovered.  We  must, 
therefore,  ascribe  it  to  some  peculiar  animal  principle 
generated  under  unknown  conditions. 


PUTRESCENT    AND    POISONED    MEAT.  329 

Putrescent  or  decayed  meat,  if  eaten  by  man,  will  produce 
not  only  gastro-enteric  symptoms  similar  to  those  described 
above,  but  also  those  of  a  typhoid  character,  or  septicemia, 
or  true  blood  poisoning.  The  game  that  has  been  kept  long 
enough  to  delight  the  taste  of  the  epicure  has  produce'd  a 
severe  cholera  in  persons  not  accustomed  to  its  use. 

Putrid  animal  matter  injected  into  the  blood  vessels 
proves  quickly  fatal.  Dissecting  wounds  thus  may  pro- 
duce alarming  symptoms,  which  may  terminate  in  death. 

Poisoned  meat. — The  flesh  of  an  animal  or  bird  which  has 
become  poisoned  by  arsenic,  strychnine,  or  some  other 
deleterious  substance,  may  become  the  cause  of  poisoning 
to  man.  Thus,  the  common  pheasant  of  this  country 
(Tetrao  umbellus)  which  has  fed  upon  the  leaves  and  buds  of 
the  kalmia  {laurel),  has  proved  poisonous  to  persons  who 
have  eaten  the  birds.  It  is  well  known  that  the  milk  of 
cows  and  goats  that  have  fed  upon  the  Datura  stramonium 
may  prove  poisonous  to  those  partaking  of  it.  In  one  case 
of  alleged  poisoning  by  belladonna,  the  defence  was  that 
the  family  had  eaten  a  rabbit  pie,  and  that  the  animal  had 
fed  upon  the  leaves  of  the  belladonna  plant,  so  that,  without 
being  affected  injuriously  itself,  it  had  conveyed  the  poison 
to  those  who  had  partaken  of  it. 


5* 


330  TOXICOLOGY. 


CHAPTER   XXV. 

CLASS  II— NEUROTIC  POISONS. 

This  second  division  of  Poisons  embraces  those  whose 
effects  are  displayed  chiefly  on  the  great  nervous  centres — 
the  brain  and  spinal  marrow.  Their  symptoms  are  drowsi- 
ness, headache,  giddiness,  stupor,  delirium,  convulsions  and 
paralysis.  They  produce  little  or  no  irritation,  or  inflam- 
mation on  the  mucous  membrane  of  the  alimentary  canal. 
Their  morbid  effects  are  not  very  distinctly  marked.  These 
consist  of  more  or  less  fullness  of  the  cerebral  vessels,  rarely 
effusion  of  serum;  more  rarely  still,  effusion  of  blood  in  the 
brain.  Hence,  it  is  quite  impossible  to  diagnose  a  case  of 
neurotic  poisoning  by  these  lesions  exclusively. 

ORDER  I.— CEREBRAL  NEUROTICS.— (i)  NARCOTICS. 

SECTION  L— POISONING  BY  OPIUM. 

NATURE  OF  OPIUM. — POISONOUS  SYMPTOMS. — FATAL  PERIOD. — FATAL 
DOSE. —  TREATMENT.: —  MORPHIA. —  PROPERTIES. — TESTS- — MECONTC 
ACID. — TESTS. — TOXICOLOGICAL  EXAMINATION  IN  OPIUM  POISONING. 

Opium  and  its  preparations  constitute  a  very  large  pro- 
portion of  poisoning  cases,  both  in  this  country  and  Great 
Britain. 

Opium  is  the  dried  juice  of  the  capsules  of  the  poppy 
(Papaver  somniferum).  It  has  a  very  complex  composition, 
containing  numerous  active  principles,  the  chief  of  which 
arc  morphia,  mcconic  acid,  narcotina,  codeia,  narccitie,  thebaine 
and  papaverine.  In  a  medico-legal  view,  the  only  important 
ones  are  morphia  and  mcconic  acid,  since,  in  an  analysis  for 


POISONING    BY    OPIUM SYMPTOMS.  331 

the  detection  of  opium  in  a  case  of  suspected  poisoning,  the 
investigation  is  narrowed  down  to  the  discovery  and  identi- 
fication of  these  two  substances. 

It  should  be  remembered  that  different  specimens  of  opium 
differ  considerably  in  their  contained  amount  of  morphia, 
this  varying  from  two  to  thirteen  per  cent.  The  average 
may  be  taken  at  eight  per  cent,  in  Smyrna  opium.  The 
tincture  (laudanum)  of  the  shops  is  far  from  being  of  a  uni- 
form strength,  owing  to  this  variation  in  the  amount  of  the 
active  principle  in  the  opium,  and  also  to  fraudulent  dilution. 
Average  laudanum  should  contain  about  five  grains  of  opium 
to  the  fluid  drachm,  which  is  equivalent  to  one  grain  to 
twenty-five  drops.  The  black  drop  (Acetum  Opii)  is  about 
double  the  strength  of  laudanum.  Wine  of  opium  {Syden- 
ham's laudanum)  is  about  the  strength  of  laudanum. 

Symptoms. — These  vary  according  to  the  size  of  the  dose. 
A  large,  but  not  fatal  dose  occasions,  at  first,  general  excite- 
ment of  the  system,  as  evinced  by  increased  fullness  and 
frequency  of  the  pulse,  flushed  face,  brilliancy  of  the  eyes, 
and  increased  activity  of  the  brain.  This  is  soon  followed 
by  calm  repose,  which  in  turn  gives  place  to  profound  sleep. 
In  proportion  as  the  amount  of  opium  is  increased,  the  first 
period  of  excitement  is  shortened,  the  more  characteristic 
soporific  effects  manifesting  themselves  sooner.  In  such  a 
case  there  will  be  giddiness  and  drowsiness,  rapidly  passing 
into  profound  sleep  or  stupor,  from  which  it  will  be  difficult 
to  arouse  the  patient;  this  stupor  gradually  ends  in  coma. 
The  pupils  are  contracted.  At  first  the  pulse  is  full  and 
slow;  subsequently  it  becomes  weak.  The  respiration  is 
generally  slow  and  stertorous  ;  the  skin  warm,  and  the  face 
flushed.  As  the  case  advances,  the  countenance  becomes 
pale,  the  lips  livid,  the  skin  cold  and  clammy,  the  respiration 
very  slow — we  have  noticed  it  reduced  down  to  five  or  six 


332  TOXICOLOGY. 

in  a  minute;  the  muscles  are  relaxed;  convulsions  some- 
times occur  just  before  death,  but  these  are  more  common 
in  children  than  in  adults.  Sometimes  there  is  vomiting, 
which  is  to  be  regarded  as  a  hopeful  sign;  and  occasionally 
also  there  may  be  purging.  At  times,  the  skin  is  bathed  in 
a  profuse  perspiration. 

Certain  variations  in  the  above  symptoms  should  be 
noticed.  The  pupils  are  usually  strongly  contracted ; 
towards  the  termination  of  the  case  they  may  sometimes 
be  dilated.  Occasionally  one  pupil  may  be  contracted,  and 
the  other  dilated.  The  contracted  state  of  the  pupils  is 
usually  regarded  as  a  diagnostic  sign  of  opium-poisoning, 
but  Dr.  Wilks  has  shown  that  this  same  condition  of  the 
eyes  occurs  in  apoplexy  of  the  pons  varolii,  and  that  two 
cases  of  this  latter  disease  were  mistaken  for  opium-poison- 
ing (Med.  Times  and  Gaz.,  1863,  I,  p.  214).  The  same  con- 
traction of  the  pupil  occurs  also  in  uraemic  poisoning,  in  the 
course  of  Bright's  disease. 

First  appearance  of  symptoms. — This  will  depend  on  the 
size  of  the  dose,  the  form  of  administration,  and  the  condi- 
tion of  the  stomach  at  the  time.  As  a  rule,  the  symptoms 
usually  commence  within  an  hour  after  swallowing  the 
poison.  But,  if  taken  in  the  liquid  form  and  in  full  quan- 
tity, they  may  manifest  themselves  in  a  few  minutes.  We 
have  often  seen  full  narcosis  produced  in  five  to  ten  minutes 
by  the  subcutaneous  injection  of  a  quarter  of  a  grain  of 
morphia.  On  the  other  hand,  cases  are  reported  where  the 
symptoms  were  delayed,  even  after  swallowing  very  large 
doses,  for  many  hours.  Sometimes  a  partial  remission  of 
the  symptoms  occurs,  and  the  patient  gives  hopes  of 
recovery;  but  they  return  again  only  to  terminate  in  death. 
There  seems  good  reason  to  believe  that  alcohol  tends  to 
postpone  the  development  of  the  usual  symptoms  of  opium. 


POISONING  BY  OPIUM EXTERNAL  APPLICATION.  333 

Fatal  period. — The  average  duration  of  a  fatal  case  is 
from  seven  to  twelve  hours.  Cases  are  reported  where  the 
symptoms  appeared  in  thirty-five  minutes,  and  death  in 
three-quarters  of  an  hour;  whilst,  on  the  other  hand,  death 
has  been,  in  some  instances,  delayed  for  twenty-four  to  forty- 
eight  hours. 

Fatal  dose. — Four  or  five  grains  may  be  regarded  as  the 
minimum  fatal  dose  for  an  adult.  Children  are  particularly 
susceptible  to  the  action  of  this  drug;  in  very  young  infants, 
fatal  effects  have  resulted  from  taking  two  or  three  drops  of 
laudanum.  An  infant  may  be  narcotized  by  the  milk  of  a 
nurse  who  has  taken  opium. 

On  the  other  hand,  recoveries  constantly  take  place  from 
very  large  doses — even  up  to  several  ounces.  It  is  noto- 
rious that  the  human  system  soon  acquires  a  remarkable 
tolerance  for  this  narcotic  by  habit.  De  Quincey  thus 
brought  himself  to  the  daily  use  of  nine  ounces  of  lauda- 
num, which  is  equivalent  to  about  three  hundred  and  sixty 
grains  of  solid  opium. 

Occasional  instances  of  idiosyncrasy  occur,  in  which  the 
susceptibility  to  the  narcotic  influence  of  opium  is  greatly 
augmented;  and  also,  on  the  other  hand,  where  there  seems 
to  be  a  natural  tolerance  for  the  drug.  As  regards  the 
opium  habit,  we  think  there  can  be  no  doubt  of  its  ultimate 
deleterious  effects  upon  the  human  system. 

The  external  application  of  opium,  especially  to  an 
abraded  surface,  may  prove  highly  dangerous,  and  even 
fatal,  especially  in  the  case  of  infants.  Christison  relates  an 
instance  where  a  laudanum  poultice,  applied  over  the  abdo- 
men of  an  infant  to  relieve  pain,  produced  fatal  narcotism 
in  some  hours ;  and  where,  at  the  autopsy,  a  strong  odor  of 
opium  was  exhaled  from  the  body,  showing  how  completely 
the  poison  had  been  absorbed. 


334  TOXICOLOGY. 

Post-mortem  appearances. — These  are  neither  certain  nor 
characteristic.  There  is  usually  some  fullness  of  the  vessels 
of  the  brain ;  occasionally,  extravasation  of  serum  into  the 
ventricles;  very  rarely  of  blood.  Sometimes  there  is  con- 
gestion of  the  lungs  and  other  vascular  organs.  The  blood 
is  apt  to  be  fluid.  The  stomach  and  bowels  may  be  per- 
fectly natural  in  appearance.  The  odor  of  opium  may  be 
observed  in  opening  the  body.  It  is  hence  impossible  to 
diagnosticate  a  case  of  opium-poisoning  from  the  post- 
mortem appearances  exclusively. 

Treatment. — Remove  the  poison  from  the  stomach  as 
speedily  as  possible,  by  the  stomach-pump,  or  by  a  prompt 
emetic,  as  sulphate  of  zinc,  or  mustard  water.  The  next  indi- 
cation is  to  overcome  the  increasing  lethargy,  by  rousing 
the  patient,  dashing  cold  water  over  the  face  and  chest,  and 
making  him  walk  about  between  two  attendants.  He  should 
swallow  some  strong  coffee.  Atropia  should  now  be  care- 
fully administered  hypodermically,  every  half  hour,  watch- 
ing its  effects  upon  the  pupils.  Electro-magnetism  should 
be  employed,  if  the  other  remedies  fail. 

As  regards  the  antagonism  of  morphia  and  atropia,  our 
own  experiments  confirm  those  of  Dr.  John  Harley,  on  the 
lower  animals  (dogs  and  cats),  viz.,  that  in  these  animals 
there  is  no  real  antagonism  between  these  drugs.  In  the 
human  subject,  however,  we  think  the  accumulated  testi- 
mony of  physicians  as  regards  their  mutual  antidotal 
operation  cannot  be  disregarded ;  our  own  experience  in 
their   employment  also    confirms    this    opinion    {vid.  ante, 

P.  185). 

Morphia. — When  pure,  morphia  is  in  the  form  of  color- 
less rhombic  crystals,  very  bitter  to  the  taste,  very  slightly 
soluble  in  water,  soluble  in  alcohol,  especially  when  hot, 
almost  insoluble  in  chloroform  and  pure  ether,  very  soluble 


POISONING    BY    MORPHIA.  335 

in  acetic  ether.  It  is  slightly  alkaline,  forming;  salts  with 
acids.  Its  solutions,  in  common  with  the  other  alkaloids, 
are  precipitated  by  tannic  acid.  Its  salts  are  soluble  in 
water  and  diluted  alcohol,  but  insoluble  in  chloroform, 
ether,  amylic  alcohol  and  pure  acetic  ether. 

The  symptoms  produced  by  morphia  resemble  those  of 
opium,  except  that  they  ordinarily  manifest  themselves 
rather  earlier,  and  possibly  tend  to  produce  convulsions 
rather  more  frequently  than  opium.  Occasionally,  these 
convulsions  were  of  a  tetanic  character,  suggesting  the 
presence  of  strychnia. 

Fatal  dose. — One  grain  has,  on  several  occasions,  occa- 
sioned death.  We  have  known  a  case  where  three-quarters 
of  a  grain  administered  hypodermically  proved  fatal  to  a 
gentleman  within  twenty-four  hours.  On  the  other  hand 
(as  in  the  case  of  opium),  enormous  doses  have  been  swal- 
lowed with  impunity.  Dr.  Norris  reports  a  case  {Am.  Jour. 
Med.  Set,  1862,  p.  395),  where  a  druggist  took,  with 
suicidal  intent,  seventy-Jive  grains  of  sulphate  of  morphia. 
No  marked  symptoms  appeared  for  an  hour  and  a  half.  He 
then  became  unconscious,  but  under  active  treatment, 
including  extract  of  belladonna,  he  entirely  recovered  on 
the  second  day  after  the  occurrence. 

The  external  application  of  morphia  to  an  abraded  sur- 
face has  been  attended  with  fatal  effects. 

There  are  no  characteristic  post-mortem  lesions  produced 
by  morphia.  The  general  appearances  are  similar  to  those 
caused  by  opium. 

CJiemical  analysis. — There  is  no  chemical  test  for  opium, 
as  such ;  it  is  identified  by  its  sensible  properties,  and  by  its 
physiological  action  on  animals.  The  only  mode  of  identi- 
fying it  chemically  is  by  detecting  the  presence  of  its  mor- 
phia and  meconic  acid. 


336  TOXICOLOGY. 

Detection  of '  morphiW^{i)  In  the  solid  state. — Strong  nitric 
acid  dissolves  it  with  effervescence,  evolving  red  fumes,  and 
gives  an  orange-red  solution,  slowly  fading  to  yellow. 
Nitric  acid  also  produces  a  deep-red  color  with  brucia,  which, 
on  the  addition  of  protochloride  of  tin,  changes  to  a  bright 
purple;  whereas  no  change  is  produced  in  the  case  of  mor- 
phia. (2)  Strong  sulphuric  acid  dissolves  it  without  change 
of  color;  if  now  a  crystal  of  bichromate  of  potassium  be 
added,  it  acquires  a  green  color.  (3)  Neutral  perchloride 
or  persulphate  of  iron  imparts  a  deep  blue  color  to  it, 
changing  to  green  if  added  in  excess.  For  this  experiment 
no  free  acid  must  be  present.  (4)  Iodic  acid  added  to  a 
fragment  of  morphia,  along  with  freshly-made  starch,  pro- 
duces the  characteristic  blue  color  from  the  liberated 
iodine. 

2.  /;/  the  liquid  state. — (1)  Nitric  acid,  in  excess,  gives 
an  orange-red  color,  which  becomes  light  yellow  on  boiling. 
(2)  Neutral  perchloride  or  persulphate  of  iron  acts  as  on 
solid  morphia.  (3)  Iodic  acid  in  bisulphide  of  carbon  added 
to  a  solution  of  morphia  causes  a  precipitate  of  a  pink  or 
red  color,  consisting  of  iodine  dissolved  in  the  bisulphide. 
(Taylor).  (4)  Sulpho-tnolybdic  acid,  made  by  dissolving  five 
or  six  grains  of  molybdate  of  sodium  or  ammonium  in  two 
drachms  of  strong  sulphuric  acid.  A  drop  of  this  reagent 
in  contact  with  a  fragment  of  morphia  dissolves  it,  producing 
a  beautiful  violet  color,  changing  soon  to  green  and  ulti- 
mately to  a  sapphire-blue.  (5)  If  morphine  be  mixed  with 
a  little  cane-sugar,  and  treated  with  concentrated  sulphuric 
acid,  a  wine-red  color  is  produced.  (Weppen). 

The  other  tests  mentioned  in  the  books,  such  as  tcr- 
ehloride  of  gold,  iodine  in  iodide  of  potassium,  bromine  in 
hydrobromic  acid,  etc.,  are  of  less  importance 

Mcconic  Acid. — As  this  acid  is  peculiar  to  opium,  its  dc- 


OPIUM TOXICOLOG1CAL    EXAMINATION.  337 

tection  affords  positive  proof  of  the  presence  of  that  sub- 
stance. In  its  pure  state,  it  occurs  in  the  form  of  colorless 
crystals,  tolerably  soluble  in  water,  more  so  in  alcohol. 

Tests. — (i)  Perchloride  or  persulphate  of  iron  imparts  to 
either  the  solid  or  liquid  form  a  blood-red  color,  which  is 
not  removed  by  a  solution  of  corrosive  sublimate.  The 
only  fallacy  likely  to  occur  in  a  medico-legal  case  is  from 
the  presence  of  some  sulplw-cyanide  in  the  material  examined, 
as  the  slliva,  which  yields  a  similar  color  with  the  iron  salt; 
but  the  red  color  in  the  latter  case  is  instantly  discharged 
by  corrosive  sublimate. 

Strong  acetic  acid,  or  its  salts,  likewise  give  a  red  color 
with  the  ferric  salts ;  and  this  color,  moreover,  is  not  re- 
moved by  corrosive  sublimate.  But  if  the  acetate  be  pre- 
viously boiled  with  dilute  sulphuric  acid,  it  gives  no  color 
with  the  iron  salt.  (2)  Acetate  of  lead  yields  a  yellowish  - 
white  precipitate  of  meconate  of  lead.  (3)  Chloride  of 
barium  yields  a  white  crystalline  deposit  of  a  peculiar  form. 
(4)  Nitrate  of  silver  gives  a  yellowish-white  precipitate, 
which  becomes  red  on  adding  a  persalt  of  iron. 

Toxicological  examination. — Sometimes  on  opening  the 
stomach  the  strong  odor  of  opium  is  readily  detected,  and 
also  in  the  matters  vomited.  The  discovery  of  this  poison  in 
the  stomach  is  often  unsuccessful,  owing,  probably,  to  its  de- 
composition, and  absorption  in  the  body.  This  is  especially 
true  in  the  case  of  infants,  in  whom  a  very  few  drops  suffice 
to  destroy  life.  The  highest  authorities  unite  in  declaring 
that  the  analyst  will  fail  to  discover  this  poison  in  the 
stomach  after  death,  in  the  majority  of  the  cases.  It  is 
much  more  likely  to  be  found  in  the  vomit. 

The  stomach  should  be  cut  up  in  small  fragments,  adding 
water  with  a  little  alcohol,  and  acidulating  with  pure  acetic 
acid,  and  the  whole  exposed  to  a  gentle  heat,  for  about  one 


338  TOXICOLOGY. 

hour.  After  cooling,  it  should  be  strained  through  muslin, 
and  the  solid  residue  washed  with  strong  alcohol  and 
pressed,  and  the  washings  added  to  the  first  liquid.  The 
liquid  should  then  be  evaporated  over  a  water-bath  to  a 
small  volume,  and  when  cooled  filtered  through  paper.  To 
the  clear  filtrate,  acetate  of  lead  is  to  be  added  in  excess,  to 
precipitate  the  mcconatc  of  lead.  The  morphia  remains  in 
the  solution  as  an  acetate.  These  are  to  be  separated  from 
one  another  by  filtration,  and  the  solid  matter  washed  with 
water. 

(a)  The  solid  portion  (meconate  of  lead)  is  to  be  diffused 
through  water,  and  treated  with  sulphuretted  hydrogen  gas, 
which  precipitates  the  black  sulphide  of  lead,  and  leaves 
the  filtrated  meconic  acid  in  solution;  this  latter  is  concen- 
trated by  a  gentle  heat.  A  trial  test  on  a  small  portion  of 
this  liquid,  by  the  iron-salt,  may  be  made;  if  a  deep  red 
color  is  imparted,  meconic  acid  may  be  suspected  ;  to  the 
remainder  of  the  liquid,  the  other  tests  may  now  be  applied. 
If  present  in  sufficient  quantity,  meconic  acid  will  crystal- 
lize out,  on  evaporation  of  the  liquid.  If  the  quantity,  how- 
ever, be  minute,  the  liquid  should  be  carefully  concentrated 
to  a  small  volume,  and  the  characteristic  tests  employed. 

(b)  The  liquid  portion,  containing  the  morphia  in  the 
form  of  acetate,  together  with  the  excess  of  lead  acetate,  is 
to  be  treated  with  sulphuretted  hydrogen  in  order  to 
remove  the  lead  ;  then  filtered,  and  the  filtrate  concentrated 
by  gentle  heat  to  dryness.  The  residue  is  then  treated  with 
a  few  drops  of  warm  distilled  water,  and  a  portion  of  it  ex- 
amined for  morphia  by  the  nitric  acid  and  iodic  acid  tests. 
The  remaining  liquid  should  then  be  made  alkaline  by  pure 
potassium  carbonate  (diluting,  if  necessary,  with  water)  ;  it 
is  next  to  be  shaken  up  with  an  excess  of  absolute  ether, 
which  wili    take   up    the    impurities,   leaving    the    morphia 


OPIUM DETECTION  IN  THE  TISSUES  AND  BLOOD.        339 

unaffected.  The  ethereal  solution  is  removed  by  means  of 
a  pipette,  and  reserved  for  future  examination.  The  re- 
maining alkaline  solution  is  now  to  be  thoroughly  shaken  with 
two  or  three  times  its  volume  of,  either  a  mixture  of  two 
parts  of  absolute  ether  and  one  of  alcohol,  or  of  two  or 
three  volumes  of  hot  arnylic  alcohol,  or  of  a  similar  bulk  of 
acetic  ether.  By  either  of  these  processes,  the  morphia  is 
taken  up  by  the  solvent,  which  floats  upon  the  top  of  the 
mixture,  and  which  may  be  removed  by  a  pipette  and 
allowed  to  evaporate  spontaneously  on  watch  glasses. 
Ordinarily,  the  morphia  thus  recovered  is  amorphous,  and 
may  require  resolution  in  hot  alcohol,  and  to  be  crystallized 
therefrom  by  evaporation. 

In  cases  of  poisoning  by  morphia  alone  (or  one  of  its 
salts)  the  above  process  may  be  employed,  omitting  the 
acetate  of  lead,  inasmuch  as  no  meconic  acid  is  present. 

Detection  in  the  tissues  and  blood. — There  is  generally  a 
failure  to  detect  this  poison  in  the  organs  and  tissues,  or  in 
the  blood.  Yet,  on  the  other  hand,  cases  are  reported  where 
it  has  been  discovered  in  the  body  several  months  after 
death.  We  can  account  for  this  discrepancy  only  on  the 
supposition  either  that  opium  (morphia)  undergoes  some 
decomposition  in  the  living  organism,  which  interferes  with 
its  detection  by  chemical  analysis,  or  else  that  life  has  been 
prolonged  sufficiently  long  to  allow  of  its  diffusion  through- 
out the  body  so  thoroughly,  as  to  render  it  impossible  to 
detect  it  in  any  one  particular  organ ;  this  would  be 
especially  the  case  if  the  dose  had  been  comparatively 
small,  as  where  an  infant  had  died  from  a  few  drops  of 
laudanum.  There  is  some  doubt  about  the  detection  of 
these  principles  in  the  urine,  inasmuch  as  the  results 
alleged  to  have  been  produced  by  certain  reagents,  and  sup- 
posed to  indicate  the  presence  of  morphia,  or  meconic  acid, 


340  TOXICOLOGY. 

have  since  been  proved  to  be  due  to  substances  existing 
normally  in  the  urine. 

The  toxicologist  should  be  cautioned  against  a  too  hasty- 
conclusion  as  to  the  presence  of  opium,  or  its  alkaloid,  in  a 
medico-legalcase,  based  upon  the  color  alone.  Orfila  tells 
us  {Toxicol.,  II,  p.  232)  that  Mm.  Ruspini  and  Cogrossi  found 
that  a  decoction  of  a  calf's  intestines,  although  no  morphia 
was  present,  acted  upon  iodic  acid  and  starch  like  that  alka- 
loid. In  another  case,  morphia  was  pronounced  to  be 
present  in  the  urine,  by  reason  of  the  action  of  the  extract 
of  this  secretion  on  iodic  acid ;  the  effect  was  found  to  be 
really,  due  to  uric  acid  and  urate  of  ammonia. 

Inasmuch  as  the  symptoms  of  opium-poisoning  strongly 
resemble  those  of  apoplexy,  it  could  readily  happen  that  a 
case  of  the  latter  disease,  attended  with  suspicious  sur- 
roundings, might  be  mistaken  for  the  former,  and  the  con- 
tents of  the  stomach  might  even  probably  reveal  a  red 
color,  when  treated  with  nitric  acid.  But,  if  no  morphia 
(nor  meconic  acid)  was  actually  separated,  we  think  the 
examiner  would  not  be  authorized  to  pronounce  upon  the 
presence  of  this  poison  simply  from  the  one  single  reaction 
above  mentioned.  Prof.  Taylor  cites  an  instructive  illus- 
tration of  this  hasty  conclusion,  in  which  a  certain  distin- 
guished (?)  chemist  made  oath  of  the  discovery  of  "  distinct 
traces  of  morphia  "  in  the  stomach ;  whereas,  in  reality,  no 
morphia  had  been  taken  at  all  (as  was  proved  by  an  analysis 
of  the  medicine  taken  by  the  deceased) ;  but  the  death  was 
due  entirely  to  natural  causes. 


POISONING    BY    ALCOHOL SYMPTOMS.  341 

SECTION  II. 
POISONING  BY  ALCOHOL. 

ACUTE     ALCOHOLISM. — SYMPTOMS. — POST-MORTEM     LESIONS. — CHEM- 
ICAL ANALYSIS. — DETECTION    IN   THE  TISSUES. 

The  poisonous  effects  of  Alcohol  are  of  a  twofold  char- 
acter— acute  and  chronic.  The  former  are  witnessed  in 
those  cases  where  a  large  quantity  of  spirits  is  taken  at  a 
single  draught,  as  in  a  silly  bravado,  or  for  a  wager,  and 
also  accidentally  by  young  children.  The  latter  are  illus- 
trated in  the  common  dram  drinkers,  and  by  a  train  of 
symptoms  with  which  we  are,  unfortunately,  but  too  familiar. 
The  former  only  will  be  discussed  here. 

Symptoms  of  acute  poisoning. — These  come  on  usually  in 
a  few  minutes  after  the  ingestion  of  the  poison,  if  the  amount 
is  large.  They  are,  first,  giddiness,  confusion  of  ideas,  un- 
steadiness of  gait,  incoherent  talking,  followed  by  stupor 
and  coma.  The  features  have  a  vacant,  ghastly  expression, 
or  they  may  be  suffused  and  bloated ;  the  lips  are  livid  ;  the 
pupils  usually  dilated  and  fixed ;  the  conjunctivae  are  red; 
an  alcoholic  exhalation  from  the  breath  is  perceived;  con- 
vulsive movements  of  the  limbs  ;  respiration,  at  first  sterto- 
rous, becomes  more  and  more  difficult ;  a  bloody  froth  may 
appear  on  the  lips;  involuntary  evacuations  occur,  and  death 
may  ensue  in  half  an.  hour,  or  even  earlier,  after  the  fatal 
drink  (Tardieu).  In  other  instances,  the  person  may  appa- 
rently recover  from  the  first  effects,  and  then  suddenly  be- 
come insensible,  and  die  in  convulsions.  If  free  vomiting 
occurs,  followed  by  a  prolonged  sleep,  recovery  is  apt  to 
take  place.  The  sensibility  of  the  pupil  to  light  may  also 
be  regarded  as  a  favorable  symptom. 

The  rapidity  with  which  the  symptoms  show  themselves 
will  depend  upon  the  previous  habit  of  the  individual,  and 


S42  TOXICOLOGY. 

the  strength  and  quantity  of  the  spirit  taken.  The  very 
large  quantities  seem  to  destroy  life  by  shock. 

Acute  alcoholism  may  be  mistaken  for  opium-poisoning 
and  concussion  of  the  brain.  Usually,  the  odor  of  the 
breath  is  sufficient  to  reveal  the  case;  also,  the  dilated 
pupil ;  but  this  condition  of  the  eye  is  not  invariably  present. 
In  concussion,  there  are  often  marks  of  injury  in  the  head; 
the  face  is  pale  and  cold ;  there  is  also  an  absence  of  the 
alcoholic  odor. 

Post-mortem  appearances. — There  is  generally  a  remark- 
able absence  of  putrefaction  in  the  body.  The  stomach 
exhibits  marks  of  intense  congestion,  in  the  deep-red  color 
of  its  lining  membrane,  either  diffused  or  in  patches.  More 
or  less  congestion  of  the  brain  and  its  membranes,  with 
serous  effusion  under  the  arachnoid,  and  in  the  ventricles. 
Sometimes,  there  is  a  true  apoplectic  extravasation  of  blood. 
The  lungs  are  almost  invariably  congested.  Usually,  a 
strong  alcoholic  odor  is  perceived  from  the  different  tissues 
of  the  body;  but  the  organs  for  which  the  poisonous  fluid 
displays  the  greatest  affinity  are  the  brain  and  liver. 

Alcohol  is  very  rapidly  absorbed  into,  and  eliminated  from 
the  system  ;  so  that,  if  the  person  has  survived  several 
hours,  all  traces  of  it  may  have  been  removed  from  the 
body. 

Treatment. — Immediate  evacuation  by  means  of  the 
stomach  pump,  or  by  an  active  emetic ;  affusion  of  cold 
water  over  the  head ;  a  free  supply  of  fresh  air  ;  if  there  be 
asphyxia  galvanism  may  be  tried,  also  ammonia  and  the 
liberal  use  of  coffee  as  a  drink. 

Chemical  analysis. — If  the  case  has  not  been  too  pro- 
tracted, the  alcohol  may  be  recovered  from  the  stomach  and 
its  contents  by  distillation  in  a  capacious  retort,  on  a  water- 
bath,  with  a  good  condensing  apparatus.     If  the  materials 


ALCOHOL — DETECTION    IN   THE    TISSUES.  3^13 

are  acid,  they  should  first  be  neutralized  by  carbonate  of 
potassium  or  sodium.  The  distillate  should  be  mixed  with 
chloride  of  calcium,  and  re-distilled.  The  second  distillate 
is  to  be  shaken  with  an  excess  of  carbonate  of  potassium 
(which  absorbs  the  water)  and  set  aside.  The  stratum  of 
alcohol  which  rises  to  the  top  may  then  be  separated  by 
means  of  a  pipette,  and  submitted  to  the  following  tests  : 
(i)  Its  taste  is  hot  and  pungent;  its  odor  is  characteristic. 
It  burns  with  a  pale  blue  flame,  leaving  no  carbonaceous 
residue,  but  yielding  carbonic  acid  and  water ;  if  burnt 
under  the  mouth  of  a  test-tube  moistened  with  lime  or  lead 
water,  the  carbonic  acid  will  produce  a  white  film  upon  the 
sides  of  the  tube.  (3)  It  dissolves  camphor.  (4)  On  adding 
a  solution  of  bichromate  of  potassium  and  sulphuric  acid, 
the  peculiar  odor  of  aldehyde  is  developed,  along  with  the 
green  color  of  chrome  oxide.  In  performing  this  latter  test, 
Prof.  Taylor  recommends  conducting  the  vapor  from  the 
retort  in  which  the  distillation  is  going  on  into  a  glass  tube 
containing  a  few  fibres  of  asbestos  moistened  with  a  mix- 
ture of  a  strong  solution  of  the  bichromate  and  sulphuric 
acid,  when  the  merest  trace  of  alcohol  vapor  will  be 
sufficient  to  impart  the  green  coloration. 

Both  ether  and  pyroxylic  spirit  (wood  spirit)  will  produce 
this  last  effect,  and  likewise  yield  most  of  the  results  of 
alcohol.  Ether  may  be  distinguished  by  its  odor,  and  by 
the  yellow  color  of  its  flame ;  also  by  its  smoky  deposit  on 
porcelain.  Pyroxylic  spirit  may  be  recognized  by  its 
peculiar  odor,  and  by  its  smoky  flame  on  burning. 

In  the  tissues. — The  proof  of  the  absorption  of  alcohol  is 
afforded  in  its  detection  in  the  blood,  urine,  and  different 
tissues  of  the  body.  If  there  is  a  failure  to  discover  it  in 
the  stomach,  it  should  be  looked  for  in  the  brain  and  liver. 
Buchheim  has  devised  an  exceedingly  delicate  process  for 
detecting  it  in   small  quantities   in   the  blood  and   tissues, 


344  TOXICOLOGY. 

based  upon  the  conversion  of  the  vapor  of  alcohol  into 
aldehyde  and  acetic  acid  when  passed  over  platinum-black. 
As  much  as  possible  of  the  material,  neutralized  first  by- 
carbonate  of  potassium,  should  be  distilled  from  a  capacious 
retort,  on  a  water-bath.  The  neck  of  the  retort  should  be 
slightly  inclined,  and  be  wide  enough  to  hold  a  platinum 
tray  about  two  inches  long  and  half  an  inch  wide,  containing 
the  platinum-black.  Hanging  over  each  end  of  the  tray  is 
placed  a  slip  of  moistened  litmus  paper,  and  touching  the 
platinum-black.  The  tray  is  now  pushed  toward  the  body 
of  the  retort.  As  soon  as  there  is  any  escape  of  alcoholic 
vapor  by  the  distillation,  it  will  be  manifested  by  the  red- 
dening of  the  litmus  paper  at  the  farthest  end  of  the  tray,  in 
consequence  of  the  production  of  acetic  acid,  while  the 
paper  nearest  the  body  of  the  retort  will  remain  blue.  If 
no  reddening  of  the  paper  occurs,  no  alcohol  can  be  present ; 
if  the  reddening  rapidly  occurs,  the  tray  should  be  removed, 
and  the  vapor  should  be  condensed  in  the  usual  way. 

As  both  ether  and  wood  spirit  produce  a  similar  effect  on 
platinum-black,  this  process  offers  no  advantage  over  the 
chromic  process  above  described,  except  when  putrefaction 
has  taken  place,  in  which  case  the  sulphuretted  hydrogen 
evolved  might  reduce  the  chromic  acid,  but  it  would  not 
affect  the  platinum-black  (Taylor  On  Poisons,  p.  643).  But 
we  may  remark  it  is  hardly  supposable  that  the  analyst 
would  undertake  to  separate  alcohol  from  a  putrefied 'body. 

A  new  test  for  alcohol  is  given  by  Lieben  (Phar.  Jour. 
1869).  A  few  grains  of  iodine  and  a  few  drops  of  solution 
of  caustic  soda  are  introduced  into  a  test-tube,  along  with 
the  suspected  fluid.  It  is  then  heated  without  boiling,  when 
iodoform  is  precipitated.  It  is  stated  that  one  part  of 
alcohol  in  two  thousand  of  the  mixture  can  thus  be  de- 
tected ;  also,  that  it  may  thus  be  discovered  in  the  urine 
after  drinking,  by  first  distilling  it. 


POISONING    BY    ETHER.  345 


CHAPTER    XXVI. 

(2)     AN/ESTHETICS. 

This  subdivision  of  Cerebral  Neurotics  comprises  those 

substances   that   display  their  power   chiefly  by  producing 

insensibility  to  pain,  and  unconsciousness.    The  Anaesthetics 

here  noticed  are  Ether  and  Chloroform.     Under  this  head 

also    it  will  be  convenient  to  speak    of   CJdoral  Hydrate, 

although    its    action    differs    somewhat   from    that   of  the 

others. 

section   1. 

POISONING     JiV     ETHER,  CHLOROFORM,    AND    CHLORAL 
HYDRATE. 

Ether. — Generally  known  as  Sulphuric  ether,  because  pro- 
cured by  the  distillation  of  alcohol  and  sulphuric  acid.  It  is 
a  limpid,  colorless  liquid,  of  a  peculiar  odor,  and  hot,  pungent 
taste;  highly  volatile  and  inflammable;  sp.  gr.  0.735  ;  boils 
at  950  F.;  burns  with  a  bright  yellow  flame,  depositing 
carbon  on  a  cold  porcelain  surface.  Sparingly  soluble  in 
water ;  very  soluble  in  alcohol. 

Symptoms. — In  large  doses,  it  produces  much  the  same 
effects  as  alcohol.  There  is,  usually,  a  short  period  of 
delirious  excitement,  followed  by  coma  and  other  symptoms 
of  narcotism,  similar  to  those  caused  by  alcohol. 

Post-mortem  appearances. — On  account  of  its  less  solu- 
bility in  water,  ether  is  a  more  powerful  local  irritant  than 
alcohol.  The  mucous  lining  of  the  stomach  and  duodenum 
of  a  dog  poisoned  with  ether  were  found  to  be  violently 
inflamed ;  the  lungs  deeply  congested,  and  the  heart  full  of 
black  blood  (Orfila,  Toxicol.,  II,  p.  531). 
16 


346  TOXICOLOGY. 

The  inhalation  of  ether,  as  is  well  known,  produces  rapid 
anaesthesia,  on  account  of  its  prompt  and  speedy  action  on 
the  brain.  Its  immediate  effect,  when  inhaled,  is  the  pro- 
duction of  a  transient  excitement ;  this  is  soon  followed,  if 
the  dose  be  sufficient,  by  stupor  and  insensibility.  This 
last  condition  may  be  prolonged  for  a  considerable  time  by 
continuing  the  inhalation.  Occasionally,  the  excitement  is 
of  a  violent  character,  along  with  a  stubborn  resistance  to 
the  anaesthetic  influence ;  and  again,  there  may  be  nausea 
and  vomiting.  These  exceptional  symptoms  must  be 
ascribed  to  the  constitutional  peculiarities  of  the  patients. 

Although,  in  a  few  instances,  the  inhalation  of  ether  has 
been  attended  with  fatal  consequences,  we  are  of  the  opinion 
that  it  is  a  much  safer  anaesthetic  than  chloroform. 

Chemical  analysis. — Ether  is  recognized  by  its  odor  and 
taste,  by  its  mode  of  combustion  and  volatility,  and  by  its 
action  on  sulphuric  acid  and  bichromate  of  potassium — the 
same  as  in  the  case  of  alcohol. 

From  organic  mixtures,  as,  e.  g.t  the  contents  of  the 
stomach,  it  is  to  be  separated  by  the  same  process  as  that 
described  for  alcohol  {vid.  p.  343). 

Chloroform. — A  colorless,  limpid  liquid,  very  volatile, 
giving  off  a  dense  vapor;  sp.  gr.  1.497;  boiling  point,  1420  F. 
It  has  an  agreeable  characteristic  odor,  and  a  smart,  pungent 
taste.  It  is  nearly  insoluble  in  water,  in  which  it  sinks  in 
globules.  It  is  not  inflammable,  like  ether  and  alcohol.  It 
is  a  powerful  solvent  of  many  organic  substances,  the  alka- 
loids among  others.  At  a  red  heat,  its  vapor  is  decomposed 
into  chlorine  and  hydrochloric  acid. 

Symptoms. — A  large  dose  produces  local  irritation  to  the 
stomach,  with,  at  first,  a  general  stimulation  of  the  whole 
system,  soon  followed  by  decided  narcotism,  as  shown  by 


POISONING   BY    CHLOROFORM.  347 

insensibility,  stupor,  convulsions,  dilated  pupils,  flushed  face, 
full  and  oppressed  pulse,  and  frothing  at  the  mouth.  Cases 
are  reported  where  the  pupils  were  contracted. 

Dr.  Taylor  reports  a  case  where  a  boy,  aged  four  years, 
died  in  about  three  hours,  after  swallowing  one  drachm  of 
chloroform.  It  has  often  caused  death  in  quantities  of  half 
an  ounce  and  upward. 

When  taken  by  inhalation,  its  impression  is  more  speedy 
than  that  by  ether.  There  is,  moreover,  an  absence  of  the 
previous  excitement  attendant  on  the  latter,  the  patient 
almost  immediately  passing  into  insensibility.  It  appears 
to  act  as  a  depressant  from  the  first,  and  if  not  properly 
diluted  with  atmospheric  air,  it  may  rapidly  produce  death. 
In  one  case,  the  fatal  result  took  place  in  one  minute  after 
breathing  only  thirty  drops  in  the  state  of  vapor ;  and,  in 
another  instance,  only  fifteen  drops  proved  fatal  in  a  very 
short  time.  It  is,  undoubtedly,  a  far  more  dangerous  anaes- 
thetic agent  than  ether,  and  instances  of  its  fatal  effects  are 
being  constantly  reported  in  the  medical  journals.  The 
immediate  cause  of  death  from  chloroform  vapor  appears  to 
be,  in  the  majority  of  cases,  syncope,  or  the  cessation  of  the 
heart's  action  ;  in  others,  asphyxia. 

Post-mortem  appearances. — In  death  from  liquid  chloroform, 
the  characteristic  odor  may  usually  be  recognized,  together 
with  slow  putrefaction  of  the  body,  and  persistent  rigor 
mortis.  There  is  also  much  irritation  of  the  stomach,  some- 
times accompanied  with  softening,  and  in  one  case  with 
ulceration. 

In  death  from  inhalation,  there  is  very  often  no  lesion 
discoverable.  At  times,  there  will  be  found  considerable 
congestion  of  the  lungs  and  bronchial  tubes,  and  likewise 
of  the  vessels  of  the  brain,  together  with  a  dark  and  fluid 
condition  of  the  blood. 


348  TOXICOLOGY. 

Treatment. — In  poisoning  by  liquid  chloroform,  the 
stomach  should  be  immediately  evacuated  by  the  stomach- 
pump,  or  by  a  prompt  emetic,  and  stimulants  afterward 
administered.  If  inhalation  has  caused  the  danger,  the 
chloroform  should  be  immediately  withdrawn,  and  fresh  air 
freely  admitted;  cold  affusion  should  be  applied  to  the»face 
and  chest ;  the  tongue  should  at  once  be  drawn  out  of  the 
mouth,  to  facilitate  respiration ;  artificial  respiration,  and  the 
direct  galvanic  current  should  also  be  practiced. 

Chemical  analysis. — The  odor  will  usually  be  present  in 
organic  mixtures,  such  as  the  contents  of  the  stomach. 
These  should  be  distilled  on  a  water-bath,  and  the  distillate 
re-distilled  along  with  chloride  of  calcium,  and  the  product 
subjected  to  the  proper  tests,  as  odor,  taste,  solubility,  etc. 

Toxicological  examination. — The  contents  of  the  stomach, 
or  the  organs  properly  divided  along  with  distilled  water, 
should  be  put  into  a  large  flask,  the  neck  of  which  is  fitted 
with  a  cork  perforated  to  contain  a  hard  glass  tube,  bent  at 
right  angles,  and  from  twelve  to  fifteen  inches  long.  The 
flask  is  gradually  heated  on  a  water-bath,  and  at  the  same 
time  the  middle  of  the  horizontal  tube  is  heated  red-hot  by 
a  Bunsen  flame.  At  a  red  heat,  chloroform  is  decomposed 
into  chlorine  and  hydrochloric  acid.  A  slip  of  moistened 
litmus  paper  placed  at  the  mouth  of  the  tube  is  first  red- 
dened, and  then  bleached  ;  starch  paper  wetted  with  iodide 
of  potassium  is  rendered  blue;  and  if  the  end  of  the  tube  be 
made  to  dip  into  a  solution  of  nitrate  of  silver,  the  white 
chloride  of  silver  will  be  precipitated.  The  absence  of  any 
free  hydrochloric  acid  in  the  original  material  should  be 
first  insured,  by  the  addition  of  carbonate  of  sodium. 

It  is  important  to  remember  that  if  hydrate  of  chloral  had 
been  taken  by  the  patient  just  previous  to  death,  and  the 
alkali  be  added  to  the  mixture  for  examination,  the  chloral 


POISONING    BY    HYDRATE    OF    CHLORAL.  349 

would  be  decomposed  into  chloroform,  and  produce  all  the 
above  reactions. 

There  are  certain  important  medico-legal  questions  con- 
nected with  the  administration  of  chloroform  as  an  anaes- 
thetic, with  which  the  legal  physician  should  be  familiar, 
such  as  whether  persons  asleep  may  be  chloroformed  with- 
out their  being  awakened,  and  thus  robbed  or  otherwise 
maltreated.  It  has  been  ascertained  by  direct  experiment 
that  this  effect  can  be  produced  if  the  sleep  is  profound,  but 
not  if  it  is  slight  or  partial. 

Hydrate  of  chloral. — A  solid,  crystalline  body,  result- 
ing from  the  action  of  chlorine  on  alcohol.  It  has  a  peculiar, 
disagreeable,  pungent  taste  and  smell ;  is  tolerably  soluble 
in  water;  not  inflammable.  Potassa  added  to  its  boiling 
aqueous  solution  instantly  converts  it  into  chloroform  and 
formic  acid.  It  decomposes  a  salt  of  copper,  like  grape 
sugar. 

Symptoms. — Chloral  has  been  introduced  into  medical 
practice  within  comparatively  few  years,  as  a  hypnotic.  Its 
indiscriminate  use  has  led  to  many  fatal  results.  Care 
should  always  be  exercised  not  to  repeat  the  dose  too  fre- 
quently, as  there  appears  to  be  a  tendency  to  accumulation, 
and  a  sudden  and  dangerous  action  of  the  drug.  In 
moderate  doses,  it  acts  on  the  brain  as  a  hypnotic ;  in  large 
doses,  it  produces  a  powerful  depressant  action  on  the  gan- 
glia at  the  base  of  the  brain,  and  the  spinal  cord,  causing 
feeble  action  of  the  heart  and  lungs. 

A  full  dose  usually  occasions  deep  sleep,  followed,  if  the 
quantity  be  very  large,  by  fatal  coma.  The  pulse  is  usually 
very  slow  and  feeble ;  the  face  pale  ;  respiration  slow,  the 
heart  being  ultimately  arrested  in  diastole. 

Much  discrepancy  of  opinion  exists  as  regards  the  fatal 


350  TOXICOLOGY. 

dose  of  chloral  hydrate.  Numerous  instances  are  reported 
where  ordinary  doses  of  thirty  grains  have  occasioned 
alarming,  and  even  fatal  effects  ;  while,  on  the  other  hand, 
enormous  quantities — over  an  ounce — have  been  swallowed 
with  comparative  impunity.  As  a  rule,  thirty  grains  may 
be  considered  as  a  safe  maximum  dose,  and  not  to  be 
repeated  oftenerthan  every  six  or  eight  hours. 

The  opinion  of  Liebreich,  of  Berlin,  is  that  chloral,  while 
circulating  in  the  blood,  undergoes  decomposition  into 
chloroform  and  formic  acid,  through  the  agency  of  the 
alkalies  of  the  blood. 

Chemical  analysis. — The  principle  involved  is  the  conver- 
sion of  the  chloral  into  chloroform,  through  the  agency  of 
an  alkali,  as  explained  above.  The  solid  matters,  properly 
divided,  should  be  diluted  with  distilled  water  and  rendered 
alkaline  by  caustic  potassa,  and  heated  in  a  flask,  and  the 
experiment  conducted  after  the  manner  described  under  the 
head  of  Chloroform. 


POISONING    BY    NUX   VOMICA.  351 


CHAPTER    XXVII. 

ORDER  II.— SPINAL   NEUROTICS   OR    TETANICS.— POISONING 
BY  NUX  VOMICA.— STRYCHNIA. 

POISONOUS  DOSE  OF  NUX  VOMICA. — EFFECTS  OF  STRYCHNIA. — FATAL 
DOSE.  —  TREATMENT.  —  POST-MORTEM  LESIONS.  —  DIAGNOSIS.  — 
CHEMICAL  ANALYSIS. —  INTERFERENCES. —  PHYSIOLOGICAL  TEST. — 
TOXICOLOGICAL   EXAMINATION. 

Nux  Vomica  is  by  far  the  most  important  poison  included 
under  this  order  of  Neurotics.  It  is  the  seeds  of  the  Strych- 
nos  nux  vomica,  a  tree  growing  in  India.  Several  seeds  are 
enclosed  in  a  yellow  fruit.  These  seeds  are  circular  disks, 
an  inch  or  less  in  diameter,  concavo-convex,  of  a  light 
brown  color,  covered  over  with  short,  whitish,  silky  hairs, 
extremely  tough  and  difficult  to  pulverize ;  excessively 
bitter  to  the  taste.  They  contain  two  powerfully  poisonous 
alkaloids — strychnia  and  brucia,  in  combination  with  stryeJi- 
uic  or  igasuric  acid.  The  amount  of  contained  strych- 
nia is  estimated  at  one-half  to  one  per  cent,  of  the  seed. 

The  smallest  fatal  dose  of  nux  vomica  is  thirty  grains 
(about  the  weight  of  one  seed),  and  three  grains  of  the  alco- 
holic extract.  The  symptoms,  treatment,  etc.,  are  precisely 
similar  to  those  described  under  the  head  of  Strychnia. 

Strychnia. — Exists  in  several  species  of  St/ ycluws  besides 
the  5.  nux  vomica ;  it  is  the  poisonous  principle  of  the 
5.  Ignatia,  or  St.  Ignatius  bean ;  it  is  also  found  in  False 
Augustura  bark. 

Strychnia  is  a  very  frequent  cause  of  poisoning,  whether 
accidental,  homicidal,  or  suicidal.     The   celebrated  Palmer 


352  TOXICOLOGY. 

case,  which  occurred  in  England,  in  1S56,  brought  it  prom- 
inently before  toxicologists. 

Symptoms. — These  vary  somewhat  in  the  time  of  their 
appearances,  according  to  the  form  of  their  administration. 
The  first  effect  is  a  feeling  of  restlessness  and  general  un- 
easiness, with  a  sense  of  impending  suffocation,  and  want  of 
air.  Very  soon,  twitching  of  the  muscles  and  jerking  of  the 
limbs  and  head  come  on.  These  are  followed  suddenly  by 
a  violent  tetanic  convulsion,  which  pervades  the  whole 
body ;  the  legs  are  stretched  out  stiffly,  and  widely  sepa- 
rated ;  the  feet  arched,  and  usually  turned  in ;  the  arms  are 
flexed,  and  tightly  drawn  across  the  chest ;  the  head  is  bent 
back  rigidly,  and  the  whole  body  flexed  backwards  so  as  to 
rest  upon  the  head  and  heels  {opisthotonos).  As  the  muscles 
of  the  chest  and  abdomen  are  spasmodically  contracted,  the 
respirator}^  movements  become  arrested;  the  face  is  livid 
and  congested,  especially  around  the  lips  ;  the  eyes  promi- 
nent and  staring;  pupils  widely  dilated;  the  muscles  about 
the  mouth  contracted  so  as  to  produce  the  expression  de- 
nominated visits  sardonicus ;  the  pulse  is  very  rapid  and 
feeble.  Sometimes,  there  is  foaming  at  the  mouth,  and  the 
froth  ma}f  even  be  tinged  with  blood.  The  intellect  remains 
perfectly  clear,  while  the  patient  is  experiencing  the  most 
intense  suffering,  gasping  for  breath,  and  seeking  in  vain  for 
relief  in  asking  to  be  turned  over,  or  moved,  or  held.  The 
iaws  are  not  always  fixed  during  a  paroxysm  ;  the  patient 
may  hence  be  able  to  speak  ;  and  as  there  is  often  great 
thirst,  he  may  ask  for  water,  but  the  effort  to  swallow  is  apt 
to  intensify  the  spasm,  as  in  hydrophobia,  and  cause  him  to 
bite  upon  the  vessel. 

The  paroxysm  may  last  from  half  a  minute  to  several 
minutes,  when  a  complete  relaxation  occurs ;  the  patient 
now   feels  exhausted,  and   is  bathed   in   perspiration;   the 


POISONING    BY    STRYCHNIA.  353 

pupils  may  now  become  contracted.  In  a  short  time — vary- 
ing from  a  few  minutes  to  half  an  hour — the  fit  returns.  It  is 
i  sually  preceded  by  an  apprehension  of  the  impending 
danger,  the  special  senses  being  exceedingly  acute.  The 
spasm  may  be  brought  on  by  the  slightest  cause,  as  the 
opening  of  a  door,  a  sudden  noise,  a  current  of  air,  or  an 
attempt  to  move.  In  some-  instances,  the  violence  of  the 
spasm  is  so  great  as  to  jerk  the  patient  out  of  bed.  Should 
the  case  prove  fatal,  the  paroxysms  increase  in  frequency 
and  violence,  until  at  last  death  ensues,  either  from  asphyxia, 
the  patient  dying  in  a  paroxysm,  or  from  pure  exhaustion, 
during  an  interval. 

Although  the  intelligence  continues  unimpaired  during 
the  progress  of  the  disease,  it  may  happen  that  it  becomes 
clouded  just  before  the  fatal  termination,  in  consequence  of 
the  asphyxia  causing  a  deficiency  of  aeration  of  the  blood, 
and  the  consequent  accumulation  of  carbonic  acid.  As  a 
rule,  when  the  paroxysms  are  once  established,  they  progress 
either  to  a  fatal  termination,  or  toward  a  cure,  within  two 
hours  of  the  seizure,  though  there  may  be  some  exceptions 
to  this  rule. 

The  time  of  the  first  manifestation  of  the  symptoms  varies 
from  a  few  minutes,  to  some  hours;  the  average  is  fifteen' 
minutes,  to  half  an  hour.  Dr.  G.  H.  Barker  reports  (Am. 
four.  Med.  Sei.,  October,  1864)  the  case  of  a  young,  healthy 
woman,  who  took  six  grains  of  strychnia,  in  whom  violent 
symptoms  were  manifested  in  three  minutes,  and  death  took 
place,  in  a  convulsion,  in  half  an  hour.  In  Dr.  Warner's 
case,  who  took,  it  is  supposed,  less  than  half  a  grain,  the 
symptoms  appeared  in  five  minutes,  and  death  occurred  in 
about  eighteen  minutes.  In  a  case  mentioned  in  the  Ann. 
d'  Hygiene,  1861,  I,  p.  133,  convulsions  came  on  in  five 
minutes.  On  the  other  hand,  this  interval  may  be  pro- 
16* 


354  TOXICOLOGY. 

tracted  for  several  hours.  Dr.  Anderson  reports  {Am.  Jour. 
Med.  Sei.,  April,  1848)  the  case  of  a  gentleman  who  took, 
by  mistake,  three  and  a  half  grains  of  strychnia,  and  expe- 
rienced no  particular  symptoms  for  two  hours  and  a  half, 
when  he  suddenly  fell  backward;  but,  on  being  raised,  he 
was  able  to  walk  home,  and  finally  recovered.  Undoubtedly, 
the  form  in  which  the  poison  is  administered  has  much  to 
do  with  the  rapid  development  of  the  symptoms.  This  is 
shown  in  a  case  cited  by  Dr.  Taylor  (Prin.  and  Prac.  of  Med. 
Jurisp.,  1873,  p.  405),  of  a  boy  aged  twelve  years,  who  swal- 
lowed a  pill  containing  three  grains  of  strychnia,  in  whom 
no  symptoms  were  manifested  for  three  lionrs  ;  they  then  set 
in  with  their  usual  violence,  and  death  took  place  in  ten 
minutes.  This  pill  had  been  prepared  with  mucilage  eight 
months  before,  and  was  consequently  hard  and  difficult  to 
dissolve.  In  the  Palmer  case,  Cook  took  two  pills  con- 
taining strychnia.  No  symptoms  were  observed  for  an 
hour  and  a  quarter,  after  which  death  occurred  in  twenty 
minutes. 

It  must,  however,  be  admitted  that  there  are  cases  where 
the  unusual  delay  cannot  be  thus  accounted  for,  but  where 
it  must  be  referred  to  some  individual  peculiarity  of  the 
patient.  Dr.  Worm  ley  [Micro.  CJiem.  of  Poisons,  p.  40)  men- 
tions a  case  where  the  remarkable  postponement  of  the 
symptoms  for  twelve  hours  appeared  to  be  owing  to  the 
effects  of  a  large  dose  of  opium  that  had  been  taken  simul- 
taneously. Three  grains  of  strychnia,  a  drachm  of  opium, 
and  an  indefinite  quantity  of  quinine  were  taken  at  the 
same  time  (ind.  ante.,  p.  184).  Other  equally  remarkable 
instances  might  be  adduced,  showing  the  same  apparent 
antagonism  between  strychnia  and  opium.  Nevertheless,  in 
some  experiments  of  the  author,  made  on  animals  with 
strychnia  and  morphia   combined,  the  latter  poison,  so  far 


POISONING    BY    STRYCHNIA FATAL    PERIOD.  OOO 

from  antagonizing  the  former,  appeared  rather  to  intensify 
it  (vid.  ante.,  p.  185). 

The  subcutaneous  injection  of  strychnia,  as  also  its  ex- 
ternal application  to  a  healthy  mucous  surface,  produces  a 
still  more  speedy  manifestation  of  its  peculiar  symptoms. 
Some  clinical  experiments  of  Dr.  Chisholm,  of  Baltimore, 
made  on  amaurotic  patients,  would  seem  to  show  that  the 
human  system  acquires  a  tolerance  of  strychnia  (Am.  Jour. 
Med.  Set.,  April,  1872). 

Fatal  dose. — There  is  great  difference  as  to  the  suscepti- 
bility to  the  action  of  strychnia.  The  average  medicinal 
dose  is  about  the  one-sixteenth  of  a  grain,  though  it  is  cus- 
tomary to  commence  with  a  smaller  quantity.  The  above 
dose  has  proved  fatal  to  a  child  between  two  and  three  years 
old.  Dr.  G.  B.  Wood  mentions  the  case  of  a  lady  who 
wast  hrown  into  alarming  spasms  by  one-twelfth  of  a  grain 
(Thcrap.  I,  p.  834).  The  author  has  seen  the  case  of  a 
gentleman  who  had  decided  spasms  after  taking  about 
one-twentieth  of  a  grain. 

The  smallest  fatal  dose  for  an  adult  recorded  is  half  a 
grain,  which  proved  fatal  to  Dr.  Warner.  Dr.  Ogston  reports 
a  case  where  three-quarters  of  a  grain  destroyed  a  man  in 
three-quarters  of  an  hour.  A  fatal  dose  for  an  adult  may 
be  stated  to  be  half  a  grain,  to  one  grain. 

On  the  other  hand,  numerous  instances  are  recorded  of 
recoveries  after  enormous  doses  of  this  poison — ten,  twelve, 
and  even  forty  grains.  In  all  these  cases  early  vomiting 
was  produced,  which,  doubtless,  removed  the  strychnia 
before  it  was  absorbed  to  a  fatal  extent.  Besides,  it  is  quite 
possible  that  the  poison  was  not  of  full  strength. 

Fatal  period. — This,  like  the  fatal  dose,  is  liable  to  con- 
siderable variation.  Dr.  Warner's  case  terminated  fatally  in 
eighteen  minutes.     Dr.  Taylor  mentions  two  cases  in  which 


356  TOXICOLOGY. 

death  occurred  in  ten  and  fifteen  minutes  respectively  ;  in 
another  case,  in  five  minutes ;  in  two  others,  in  thirty 
minutes  each. 

On  the  other  hand,  life  has  been  prolonged,  even  after 
large  doses,  for  several  hours.  In  Cook's  case,  death 
occurred  in  an  hour  and  a  quarter  after  swallowing  the  pill. 
In  the  case  of  a  woman  examined  by  the  author,  death  did 
not  occur  for  six  hours  after  swallowing  about  six  grains  of 
strychnia  {Am.  Jour.  Med.  Sei.,  Oct.,  1861,  p.  409).  Sir  R. 
Christison  reports  a  case  in  which  a  man  died  in  fifteen 
minutes  after  swallowing  a  dose  of  nux  vomica. 

Treatment. — Prompt  and  free  emesis  is  of  the  greatest 
importance.  Copious  draughts  of  warm  mustard  water,  or 
a  mixture  of  ipecac  and  sulphate  of  zinc  should  be  given. 
The  stomach  pump  may  be  used  if  the  spasm  of  the  jaws 
will  permit.  Chloroform,  by  inhalation,  appears  to  have 
been  attended  with  the  happiest  results.  The  patient  should 
be  constantly  kept  under  its  influence,  carefully  watching  its 
effects.  YVe  would  strongly  advise  its  early  administration. 
Bromide  of  potassium  has  also  been  given  with  the  best 
results — sixty  to  eighty  grains  every  hour,  or  half  hour. 
Hydrate  of  cliloral  has  also  proved  an  efficient  remedy  in 
several  cases,  and  nitrite  of  amy/  has  been  recommended, 
from  its  known  physiological  effects.  Atropia  has  also 
proved  efficacious  as  an  antidote  in  a  case  where  chloroform 
failed,  and  where  the  paroxysms  were  very  severe  (Ed. 
Med.  Jour.,  Sept.,  1873). 

As  regards  the  remedial  effects  of  tobacco,  tincture  of  iron, 
tincture  of  iodine  and  aconite,  we  deem  them  of  no  value. 
We  have  experimented  with  them  all  on  dogs  that  were 
poisoned  with  strychnia,  but  in  no  case  did  any  of  them 
exhibit  antidotal  powers. 

Post-mortem  appearances. — These  are  by  no  means  char- 


POISONING    BY    STRYCHNIA DIAGNOSIS.  357 

acteristic,  nor  are  they  always  similar.  Probably,  the  lesions 
most  commonly  observed  are  congestion  of  the  brain  and 
membranes,  and  of  the  spinal  cord,  with  engorgement  of  the 
lungs,  and  a  dark  and  fluid  condition  of  the  blood.  The 
heart  is  sometimes  contracted  and  empty,  and  at  others  full 
of  blood.  The  rigor  mortis  is  usually  prolonged;  in  one 
case,  we  found  it  existing  six  weeks  after  death.  There  is 
also  frequently  noticed  a  livid  appearance  about  the  mouth 
and  tongue,  and  also  of  the  fingers  and  toes.  It  should  be 
remembered  that  certain  disorders  of  the  brain  and  spinal 
cord,  attended  with  tetanic  convulsions,  will  leave  precisely 
similar  lesions  to  those  just  referred  to  as  following  death 
by  strychnia. 

Diagnosis. — The  importance  of  a  clear  diagnosis,  in  a 
medico-legal  case  of  strychnia-poisoning,  cannot  be  too 
strongly  urged,  inasmuch  as  there  may  be,  in  such  a  case, 
a  complete  absence  of  all  chemical  proof.  In  the  celebrated 
Palmer  case,  this  question  was  most  thoroughly  sifted  on 
both  sides.  Indeed,  this  very  case  affords  an  apt  illustration 
of  just  the  sort  of  difficulties  that  present  themselves  in 
forming  a  correct  appreciation  of  the  symptoms.  In  the 
Palmer  case,  the  defence  brought  forward  an  immense  array 
of  diseases,  which,  as  remarked  by  Tardieu,  "  have  but  a 
faint  resemblance  to,  and  often  a  complete  diversity  from, 
the  characteristic  phenomena  of  strychnia-poisoning."  The 
only  disease  whose  symptoms  can  possibly  be  confounded 
with  those  occasioned  by  strychnia,  is  tetanus,  in  its  varie- 
ties of  idiopathic,  traumatic  and  hysterical,  and  possibly 
some  forms  of  epilepsy. 

If  the  expert  were  obliged  to  decide  solely  from  the  con- 
vulsion— apart  from  its  mode  of  invasion  and  seizure,  its 
duration  and  termination,  the  condition  of  the  intervals 
between  the  paroxysms,  in  fine,  apart  from  the  whole  history 


35  S  TOXICOLOGY. 

of  the  attack — he  might  probably  be  unable  to  discriminate 
between  a  case  of  strychnia-poisoning  and  one  of  tetanus ; 
but  where  a  careful  examination  of  all  these  attending 
circumstances  has  been  instituted,  there  can  be  no  possible 
difficulty  in  reaching  a  satisfactory  conclusion.  The  dis- 
tinctive characters  are  the  following:  (i)  In  traumatic 
tetanus,  the  history  of  the  case,  as  being  connected  with 
some  injury,  such  as  a  lacerated,  contused,  or  punctured 
wound,  involving  tendons,  nerves  and  fasciae,  will  always 
throw  sufficient  light  on  the  case  to  admit  of  an  easy  diag- 
nosis, although  it  must  not  be  forgotten  that  the  most  trifling 
injury,  such  as  the  insertion  of  a  splinter  of  wood  beneath 
the  fascia,  and  which  may  have  entirely  escaped  recollec- 
tion, may,  after  the  lapse  of  several  days,  give  rise  to  this 
frightful  disorder ;  and  such  a  case  might  be  mistaken  for 
idiopathic  tetanus.  But  as  regards  the  latter  form  of  the 
disorder,  besides  its  extreme  rarity  in  temperate  climates, 
its  mode  of  invasion  (as  likewise  that  of  traumatic  tetanus), 
the  duration  of  the  attack  and  the  character  of  the  symptoms, 
are  entirely  different  from  those  of  strychnia-poisoning.  In 
the  former  there  are  always  manifested  certain  prodromes, 
such  as  chills,  faintness,  insomnia,  headache,  vertigo,  and 
painful  tension  about  the  diaphragm,  which  may  last  for 
several  days.  These,  of  course,  are  entirely  wanting  in 
poisoning  by  strychnia,  and  they  never  can  be  mistaken  for 
the  general  uneasiness  which  precedes  for  only  a  few  minutes 
the  sudden  outburst  of  convulsions,  in  the  case  of  the  poison. 
(2)  The  first  symptoms  in  tetanus  are  a  painful  stiffness  of 
the  neck  and  jaws,  with  a  difficulty  of  moving  the  head; 
after  this,  there  is  a  gradual  spreading  of  the  rigidity  over 
the  muscles  of  the  other  parts  of  the  body,  usually  the  trunk 
first,  then  the  limbs.  In  some  instances  the  contractions 
reach  their  greatest  intensity  in  the  course  of  a  few  hours  ; 


POISONING    BY    STRYCHNIA DIAGNOSIS.  359 

in  others,  several  days  may  elapse.  To  contrast  this  with 
a  case  of  strychnia-poisoning :  in  the  latter,  instead  of  the 
gradual  invasion  of  the  rigid  spasms,  commencing  in  the 
neck  or  jaws,  there  is  a  sudden  tetanic  seizure  of  all  the 
muscles  of  the  body  simultaneously,  producing  the  violent 
jerking  of  the  body,  and  the  arching  of  it  backwards.  Again, 
while  the  muscles  of  the  neck  and  jaws  are  never  the  first 
to  be  affected  by  strychnia,  but  are  often  the  last,  the  re- 
verse is  the  case  in  the  disease — the  trismus  being  the  first 
indication  of  its  approach.  (3)  A  third  distinction  is  founded 
on  the  progress  of  the  two  cases  :  whilst  the  violent  par- 
oxysm produced  by  strychnia  lasts  only  from  half  a  minute 
to  one  or  two  minutes,  and  is  succeeded  by  a  complete  re- 
laxation, in  tetanus,  on  the  contrary,  the  rigidity  is  generally 
permanent,  or  if  there  be  any  remissions,  these  never  ex- 
hibit the  character  of  the  complete  intermissions  character- 
izing the  action  of  strychnia.  (4)  The  termination  of  the 
cases  is  widely  different ;  idiopathic  tetanus  never  terminates 
fatally  in  two  or  three  hours,  but  usually  several  days 
elapse;  whilst  in  the  case  of  the  poison,  death  often  occurs 
within  half  an  hour,  to  two  hours.  Some  cases  of  traumatic 
tetanus  are  reported,  which  proved  fatal  within  twelve  hours  ; 
and  one  remarkable  case,  quoted  by  Watson  (Lectures,  art. 
Tetanus)^  of  a  negro  who  lacerated  his  thumb  by  the  acci- 
dental fracture  of  a  china  dish  ;  he  was  seized  with  convul- 
sions almost  instantly,  and  died  with  tetanic  symptoms  in  a 
quarter  of  an  hour. 

As  regards  the  hysterical  form  of  tetanus,  although  its 
very  existence  has  been  denied  by  some,  especially  in  the 
male,  it  is  admitted  by  numerous  competent  authorities ; 
and,  inasmuch  as  among  other  forms  it  may  assume  that  of 
tetanic  spasms,  and  might  occasion  doubt,  under  peculiar 
circumstances,  the  examiner  should  ascertain  the  previous 


360  TOXICOLOGY. 

history  of  the  case,  which  will  serve  to  clear  up  the  diag- 
nosis. 

In  relation  to  epilepsy,  there  ought  to  be  no  difficulty  in 
the  diagnosis ;  the  mode  of  seizure,  the  unconsciousness, 
and  the  peculiar  clonic  movements,  are  wholly  different  from 
the  characteristic  tetanic  spasm  of  strychnia-poisoning. 
Again,  the  deep  stupor  which  terminates  an  epileptic  attack 
contrasts  widely  with  the  complete  relaxation  and  perfect 
intelligence  that  follow  the  strychnia  spasm. 

Cliemical  analysis. — Strychnia  occurs  in  the  form  of  a 
white  powder,  and  also  in  crystals,  usually  prismatic.  It  is 
almost  insoluble  in  water — one  part  in  seven  or  eight  thou- 
sand. Absolute  alcohol  dissolves  one  part  in  about  two 
hundred ;  amylic  alcohol,  one  in  one  hundred  and  twenty  ; 
pure  ether,  one  in  about  fourteen  hundred  ;  commercial  ether, 
one  in  about  one  thousand  ;  chloroform,  one  part  in  eight. 
It  is  insoluble  in  the  fixed  alkalies,  and  very  sparingly  so 
in  ammonia. 

The  salts  of  strychnia  are  very  soluble  in  water  and 
alcohol,  but  very  slightly  so  in  ether. 

The  taste  is  intensely  and  permanently  bitter.  This  is  one 
of  its  characteristic  qualities.  In  fact,  it  is  the  bitterest  sub- 
stance known.  As  the  result  of  numerous  experiments,  we 
have  found  distinct  bitterness  yielded  by  a  solution  of  one 
grain  of  strychnia  in  several  gallons  of  water.  This  bitter 
taste  we  regard  as  one  of  the  strongest  corroborative  proofs 
of  the  presence  of  strychnia  in  a  medico-legal  case.  Unless 
the  ultimate  extract  obtained  by  the  manipulation  has  a  bitter 
taste,  we  need  hardly  expect  to  prove  the  presence  of  the 
poison  by  the  usual  chemical  tests.  But,  of  course,  the  mere 
presence  of  bitterness  is  not  evidence  of  strychnia,  since  this 
quality  pertains  to  numerous  other  substances,  such  as 
morphia,  quinia,  aloes,  colocynth,  quassia,  picrotoxia,  etc. 


POISONING    BY    STRYCHNIA THE    COLOR    TEST.  oGl 

The  strong  mineral  acids  produce  no  coloration  with 
strychnia,  provided  the  latter  is  pure ;  if  it  contains  brucia, 
it  will  impart  a  reddish  color  to  nitric  acid.  Heated  on 
porcelain,  it  melts  slowly  into  a  brown  liquid,  and  is  decom- 
posed, giving  off  dense  white  fumes,  and  leaving  carbon. 
It  may  be  sublimed  by  heat,  depositing  crystals  of  pennate 
forms  on  a  cold  glass  surface  (Guy). 

I.  The  Color  test. — This  is  so  named  on  account  of  the 
beautiful  succession,  or  play  of  colors,  that  is  developed  by 
it.  It  consists  in  the  application  of  a  drop  of  pure  sulphuric 
acid  to  a  small  fragment  of  strychnia,  on  a  white  porce- 
lain surface,  or  on  a  watch  glass  over  white  paper.  If  the 
strychnia  be  perfectly  pure,  it  will  dissolve  in  the  acid  with- 
out any  coloration.  If  now  a  fragment  of  bichromate  of 
potassium,  biuoxide  of  manganese,  bin  oxide  of  lead,ferrocya- 
nide  of  potassium,  or  permanganate  of  potassium,  be  stirred 
in  contact  with  the  solution,  by  means  of  a  pointed  glass 
rod,  this  play  of  colors  is  instantly  manifested.  At  first,  it  is 
of  a  rich,  deep  blue;  this  soon  passes  into  violet  and  purple, 
which,  in   its  turn  fades  into  a  pink,  and  finally  into  a  red. 

The  relative  duration  of  these  shades  of  color  depends 
on  the  quantity  of  strychnia  operated  on,  and  also  on  the 
relative  amounts  of  acid  and  the  other  substance.  Thus,  if 
the  amount  of  strychnia  be  extremely  minute,  the  blue 
color  may  flash  out  but  for  a  moment,  leaving  only  the 
violet  or  purple,  which  quickly  passes  into  the  red. 

The  principle  involved  in  the  color  test  is 'the  action  of 
nascent  oxygen  (developed  by  the  sulphuric  acid  on  the 
various  oxidizing  substances  above  named)  on  the  strychnin. 
For  the  success  of  the  experiment,  it  is  immaterial  which 
one  of  these  oxidizing  bodies  is  employed,  providing  it  is 
pure.  Different  authorities  evince  a  preference  for  one  or 
another,  according  to  their  individual  tastes.    As  a  rule,  the 


362  TOXICOLOGY. 

pure  crystal  of  bichromate  of  potassium  will  yield  satisfac- 
tory results. 

It  is  very  important  for  the  medico-legal  student  to  have 
clear  and  definite  ideas  about  this  color  test  for  strychnia.  I 
It  is  not  the  mere  production  of  a  blue  color  that  is  of 
diagnostic  value,  for  this  might  result  from  the  application 
of  permanganate  of  potassium  to  various  organic  bodies  in 
the  absence  of  strychnia  ;  but  it  consists  in  the  regular  suc- 
cession of  colors — from  blue  to  violet,  pink,  and  red,  the  last 
continuing  for  some  time,  and  ultimately  changing  to  a  dirty 
green.  So  far  as  is  known  at  present,  strychnia  is  the  only 
substance  that  answers  to  the  above  requisition.  There  are 
others  that  react  somewhat  similarly,  which  will  be  noticed 
hereafter. 

The  exceeding  delicacy  of  the  color-test  deserves  special 
notice.  If  the  strychnia  be  perfectly  pure,  and  the  manipu- 
lation be  properly  performed,  so  minute  a  quantity  as  the 
one-millionth  of  a  grain  can  be  detected,  as  we  have  repeat- 
edly verified  in  our  own  experience,  and  as  is  corroborated 
by  other  experimenters.  It  depends  altogether  on  the 
delicacy  of  the  experiment.  These  minute  quantities  of 
strychnia  are  best  obtained  by  first  making  a  solution  of  the 
alkaloid  in  pure  water,  with  the  addition  of  acetic  acid,  of  a 
definite  strength.  This  may  readily  be  reduced  by  the 
addition  of  more  water.  Fractional  portions  of  the  solution 
may  be  obtained  by  using  a  pipette  drawn  out  to  a  capillary 
point,  which  will  deposit  minute  droplets  on  a  warmed, 
clean  porcelain  surface.  The  object  here  is  to  concentrate 
the  quantity  to  be  experimented  upon  into  as  small  a  space 
as  possible.  The  drop  should  then  be  evaporated  to  dryness 
spontaneously.  A  small  drop  of  pure  concentrated  sul- 
phuric acid  is  then  applied  to  the  deposit,  by  means  of  a 
finely-pointed  glass  rod,  and  then  a   minute  crystal  of  the 


STRYCHNIA THE    COLOR    TEST  363 

bichromate  of  potassium  (or  one  of  the  other  oxidizing 
bodies)  is  placed  alongside  of  the  acid  solution,  and  then,  by 
means  of  the  rod,  is  drawn  through  the  solution  and  gently 
stirred  in  it. 

Interferences. — As  above  mentioned,  the  color-test,  pro- 
perly applied,  will  detect  exceedingly  minute  portions  of 
pure  strychnia,  but  there  are  many  organic  substances 
whose  presence  will  considerably  modify  and  even  com- 
pletely disguise  this  test.  This  fact  has  been  known  to 
chemists  since  1850,  when  it  was  first  announced  by  Brieger 
(C/iem.  Gaz.,  VIII,  p.  408).  His  results  have  been  con- 
firmed, and  the  list  of  interfering  bodies  has  been  extended 
by  subsequent  experimenters.  According  to  Lyman  (N.Y. 
Med.  Gaz.,  Mar.,  1871),  permanganate  of  potassium  is  the 
only  reagent  that  will  develop  the  color-test  with  strychnia, 
when  the  latter  is  mixed  with  either  morphia  or  quinia  in 
excess.  The  most  important  of  these  interferences,  con- 
sidered medico-legally,  is  probably  morphia,  inasmuch  as 
this  substance  might  be  likely  to  be  given  to  allay  the 
severity  of  the  strychnia  spasms,  and  would  consequently  be 
associated  with  the  strychnia  extracted  from  the  body  after 
death.  A  large  number  of  experiments  made  by  the  author 
{Am.  Jour.  Med.  Sci.,  Oct.,  1 861,  and  April,  1862)  clearly 
confirm  the  fact  of  the  interference  of  morphia  with  the 
usual  color-test  for  strychnia,  both  in  the  pure  state  and 
when  mixed  with  organic  matters.  One  experiment  only 
will  here  be  mentioned  :  A  small  cat  was  poisoned  "  with 
one-twentieth  of  a  grain  of  strychnia  and  one-tenth  of  a 
grain  of  morphia.  The  ultimate  extract  obtained  from  the 
stomach  by  Stas'  process  entirely  failed  to  yield  the  color- 
test,  although  the  bitterness  of  the  extract,  and  the  fact  that 
its  solution  produced  the  characteristic  tetanic  convulsions 
in  a  number  of  frogs,  distinctly  proved  its  existence." 


364  TOXICOLOGY. 

Admitting,  then,  the  fact  of  these  interferences,  it  is  well  to 
remember  that,  practically,  they  may  be  avoided,  in  a  medico- 
legal investigation,  by  the  employment  of  chloroform  in- 
stead of  ether,  as  the  solvent  to  extract  the  strychnia  from 
organic  mixtures, — morphia  and  other  interfering  substances 
being  insoluble  in  this  menstruum. 

Fallacies. — Exception  has  been  taken  to  the  color-test,  on 
the  ground  that  other  substances  besides  strychnia  will 
yield  colors  similar,  if  not  identical,  when  similarly  treated ; 
but  a  careful  attention  will  readily  avoid  all  difficulty.  The 
substances  alluded  to  are  enrarine,  veratrine,  cod-liver  oil, 
salicine,  santonine,  aniline,  pyroxanthinc \  narceine,  papaverine 
and  solanine  ;  but  in  relation  to  most  of  these,  a  radical  ground 
of  distinction  is  that  they  are  colored  by  sulphuric  acid  alone, 
which  is  not  the  case  with  strychnia.  A  salt  of  aniline  is 
not  colored  by  the  acid  alone,  but  only  in  the  presence  of 
one  of  the  above  mentioned  oxidizing  bodies;  but  there  is 
this  difference  between  it  and  strychnia :  the  former  is  first 
colored  green,  then  a  very  persistent  blue,  and  finally  black. 

Curarine  has  many  points  of  resemblance  to  strychnia;  it 
is  very  bitter;  it  yields  a  succession  of  colors  with  sulphuric 
acid  and  bichromate  of  potassium  ;  but  it  is  colored  by  sul- 
phuric acid  alone ;  it  is  nearly  insoluble  in  chloroform,  and 
readily  soluble  in  potash.  Its  physiological  effects  are  the 
opposite  of  those  of  strychnia. 

Cod-liver  oil,  when  treated  with  sulphuric  acid  alone, 
affords  a  play  of  colors  somewhat  like  those  presented  by 
strychnia. 

2.  The  galvanic  test  of  Dr.  Letherby  acts  on  the  same 
principle,  of  presenting  nascent  oxygen  to  the  strychnia ; 
but  in  this  instance  it  is  evolved  by  galvanism.  A  drop  of 
a  dilute  solution  of  strychnia  is  placed  in  a  small  depression 
made  on  platinum  foil,  or  in  a  platinum  capsule,  allowed  to 


POISONING    BY    STRYCHNIA TESTS.  365 

evaporate  to  dryness,  and  then  moistened  with  a  drop  of 
sulphuric  acid.  The  foil  (or  capsule)  is  connected  with  the 
positive  pole  of  a  single  cell  of  Grove's  battery,  and  the  acid 
is  touched  with  the  platinum  terminal  from  the  negative 
pole.  Instantly,  the  violet  color  will  flash  out  on  the  metal, 
and  on  removing  the  pole  from  the  acid,  the  tint  will  remain. 

3.  Potassa  and  ammonia  precipitate  the  alkaloid  from  a 
somewhat  concentrated  solution,  in  the  crystalline  form. 
The  best  method  is  to  expose  a  drop  of  the  solution  on  a 
glass  slide,  to  the  vapors  of  ammonia,  and  place  it  under 
the  microscope;  the  beautiful  formation  of  the  long  stellate 
prismatic  crystals  can  easily  be  distinguished  ;  these  can  be 
identified  by  touching  them  with  a  drop  of  sulphuric  acid 
and  a  fragment  of  bichromate  of  potassium,  when  the  play 
of  colors  will  take  place. 

4.  Bichromate  of  potassium. — A  solution  of  this  salt 
throws  down  from  a  strychnia  solution  a  bright  yellow  pre- 
cipitate, which  soon  becomes  crystalline.  Placed  under  the 
microscope,  these  crystals  appear  in  groups,  mingled  with 
octahedral  plates.  When  dried,  these  should  be  verified 
by  touching  them  with  a  drop  of  sulphuric  acid.  This  is  a 
satisfactory  test. 

5.  Carbazotic  (or  picric)  acid. — A  solution  of  this  acid 
precipitates  strychnia  from  its  solution  in  the  form  of 
abundant  yellow  crystals.  The  best  mode  of  showing  it  is 
to  add  a  drop  of  the  solution  to  one  of  strychnia,  on  a  glass 
slide,  and  view  the  reaction  under  the  microscope.  The  pre- 
cipitate which  first  forms  soon  assumes  the  appearance  of  tufts 
of  yellow  crystals,  of  a  peculiar  claw-like  form.  These,  as 
in  the  former  experiment,  may  be  subjected  to  the  color- 
test,  by  the  same  method. 

Besides  the  above  tests,  there  are  others  of  inferior  value 
— as  corrosive  sublimate,  ferrocyanide  of  potassium,  bicldorate 


366  TOXICOLOGY. 

of  platinum,  iodated  iodide  of  potassium,  and  sulplw-cyanide  of 
potassium. 

Tardieu  considers  chlorine  gas  to  be  a  very  delicate  test  j 
for  strychnia.  When  a  small  stream  of  this  gas  is  slowly 
passed  through  a  dilute  solution  of  strychnia,  each  bubble 
of  the  gas  becomes  surrounded  by  a  white  film,  and  ulti- 
mately, quite  a  copious,  white  amorphous  deposit  takes 
place,  which  is  soluble  in  ammonia.  According  to  the 
above  authority,  no  other  alkaloid  gives  this  reaction  with 
chlorine. 

The  physiological  or  frog  test. — The  extreme  susceptibility 
of  the  frog  to  the  action  of  strychnia  was  first  employed 
by  Dr.  Marshall  Hall,  as  a  test  for  this  poison.  It  may  be 
applied  either  by  immersing  a  small  frog  in  the  strychnia 
solution,  or  else  injecting  it  either  into  the  throat  of  the 
animal,  or  preferably,  under  the  skin.  We  have  repeatedly 
resorted  to  this  test,  and  uniformly  with  satisfactory  results. 
One  of  these  experiments  demonstrates  very  clearly  the  ex- 
treme susceptibility  of  the  frog  to  the  influence  of  strychnia. 
"  The  one  five-hundredth  of  a  grain  of  strychnia  was  put  into 
the  throat  of  a  middling-sized  frog;  it  was  convulsed  and 
died  in  about  thirty  minutes.  The  extract  obtained  from 
the  stomach  by  Stas'  process,  although  it  afforded  no  per- 
ceptible color-test,  had  a  bitterish  taste,  and  produced 
tetanic  spasms  in  several  small  active  frogs." 

Our  experiments  in  this  line  further  demonstrate  the  fact 
that  while  morphia,  when  present  in  excess,  with  strychnia 
in  small  quantities,  has  the  power  to  disguise  the  color-test, 
it  affords  no  obstacle  to  the  employment  of  the  frog-test.  Two 
experiments  only  will  be  quoted  under  this  head:  "A  frog 
weighing  thirty-five  grains  was  immersed  in  a  solution  con- 
taining one  grain  of  strychnia  and  thirty-two  grains  of  mor- 
phia   in    six  pints    of  water ;  it  was   convulsed  in   twenty 


STRYCHNIA — TOXICOLOGICAL   EXAMINATION.  367 

minutes.  Another  animal,  rather  smaller,  was  convulsed  in 
five  minutes."  (In  these  experiments  only  a  small  portion 
of  the  solution  was  used — less  than  a  fluid  drachm — put 
into  a  conical  glass,  in  which  the  hind-quarters  only  of  the 
animal  were  immersed).  "  A  cat  was  poisoned  with  one- 
twentieth  of  a  grain  of  strychnia  and  one-tenth  of  a  grain  of 
morphia.  The  stomach,  on  examination  by  Stas'  process, 
failed  to  yield  the  color-test ;  but  the  watery  solution  of  the 
extract  produced  most  decided  tetanic  convulsions  in  eight 
frogs,  generally  resulting  in  death." 

To xicological examination. — The  stomach  properly  divided, 
together  with  its  contents,  and  a  sufficient  quantity  of  dis- 
tilled water,  should  be  made  distinctly  acid  with  acetic  acid. 
If  the  elaborate  process  of  M.  Stas  is  to  be  employed,  the 
strongest  alcohol  must  be  used  instead  of  water.  In  either 
case,  the  mass  should  be  digested  on  a  water-bath  for  several 
hours.  A  high  temperature  is  objectionable,  as  it  dissolves 
out  the  starchy  matters.  After  cooling,  it  is  strained  through 
muslin,  and  the  solid  matters  washed  with  dilute  alcohol  and 
pressed.  The  liquid  should  next  be  concentrated  by  evapo- 
ration, and  filtered  through  paper.  It  should  now  be 
evaporated  to  dryness.  The  residue  will  contain  any 
strychnia  usually  present  in  the  form  of  acetate,  mixed  with 
organic  matter.  This  residue  should  now  be  'thoroughly 
mixed  with  a  small  quantity  of  distilled  water  containing  a 
few  drops  of  acetic  acid,  then  filtered  through  paper,  and  the 
filtrate  poured  into  a  glass  tube  or  flask,  and  an  excess  of 
solution  of  potassa  or  soda  (or  ammonia)  added,  which 
liberates  the  strychnia  from  its  combination.  Pure  chloro- 
form, slightly  in  excess  of  the  mixture,  is  now  added,  and  the 
whole  briskly  shaken  together  for  some  minutes.  The 
chloroform  dissolves  out  the  alkaloid,  and  from  its  gravity 
settles  to  the  bottom  of  the  mixture,  after  the  lapse  of  some 
time. 


368  TOXICOLOGY. 

In  order  to  separate  the  chloroform  from  the  supernatant 
liquid,  we  have  found  that  the  easiest  practical  method  is  t< 
transfer  the  whole  mixture  to  a  stoppered  glass  funnel,  01 
what  answers  equally  well,  a  glass  syringe  of  proper  size 
after  removing  the  piston,  and  having  previously  contractec 
the  nozzle  to  a  fine  point  by  means  of  the  flame.  Before 
introducing  the  liquid,  this  small  aperture  should  be  pluggec 
with  a  splinter  of  wood,  and  about  half  a  drachm  of  pure 
chloroform  first  poured  into  the  syringe,  so  as  to  about  fill 
the  narrow  portion.  The  mixture  is  now  to  be  carefully 
poured  in,  and  a  sufficient  time  allowed  to  elapse  for  the 
chloroform  to  separate  and  settle  to  the  bottom. 

By  placing  the  thumb  over  the  larger  aperture  of  the 
syringe,  and  withdrawing  the  wooden  plug,  it  will  be  very 
easy  to  control  the  flow  of  the  contents.  A  few  drops  may 
be  allowed  to  fall  successively,  as  each  one  dries,  into  a 
warmed  watch  glass,  or  porcelain  capsule,  for  a  trial  test,  by 
means  of  sulphuric  acid  and  bichromate  of  potassium  (vie/. 
p.  361).  The  whole  of  the  chloroform  is  then  permitted  to 
flow  out  into  one  or  more  capsules,  or  watch  glasses,  great 
care  being  taken  not  to  allow  any  of  the  other  mixture  to 
escape  along  with  it.  The  remaining  alkaline  liquid  may 
be  shaken  up  with  an  additional  portion  of  chloroform,  and 
the  separation  again  made  as  before.  All  the  chloroform  is 
now  permitted  to  evaporate  spontaneously  to  dryness.  The 
contained  strychnia,  if  of  notable  quantity,  will  be  found  in 
the  deposit,  in  an  amorphous — not  crystalline — form,  ac- 
cording to  our  experience. 

A  portion  of  this  extract  should  now  be  examined  by  the 
taste,  for  bitterness  ;  by  the  color-test  (although  this  may  not 
be  veiy  satisfactory,  on  account  of  the  mixture  with  organic 
matter) ;  and  by  the  frog-test.  The  remaining  portion  of 
the  extract  is  to  be  dissolved  in  a  minute  quantity  of  water, 


STRYCHNIA DETECTION    IN    THE   TISSUES.  369 

acidulated  with  acetic  acid,  filtered,  and  subjected  to  the 
usual  tests  (vid.  p.  361). 

The  main  difficulty  in  conducting  this  experiment  arises 
from  the  presence  of  organic  matters  in  connection  with  the 
strychnia.  If  the  chloroform  extract  has  a  ye  1  low  color 
(denoting  its  impurity),  a  few  drops  of  strong  sulphuric  acid 
should  be  added  to  it  and  thoroughly  stirred  with  a  glass 
rod.  This  destroys  and  carbonizes  all  the  organic  matter, 
but  merely  converts  the  strychnia  into  a  sulphate ;  add  a 
few  drops  of  water.  After  standing  a  short  time,  the  dark 
liquid  is  filtered,  solution  of  potassa  is  added  in  excess,  then 
pure  chloroform,  as  explained  above.  The  second  extract 
thus  procured  is  generally  sufficiently  pure  for  all  practical 
purposes. 

It  not  unfrequently  happens,  when  operating  on  complex 
organic  mixtures  by  the  chloroform  process,  that  difficulty 
is  experienced  in  getting  the  chloroform  to  separate  from 
the  alkaline  solution;  the  whole  mass  forming  a  sort  of 
emulsion.  In  such  a  case,  the  tube  may  be  immersed  in  hot 
water  for  some  time  ;  and  if  this  does  not  answer,  nothing 
remains  but  to  agitate  the  mixture  several  times  successively 
with  about  half  its  volume  of  pure  water,  allowing  it  to  rest 
each  time,  and  separating  the  chloroform  as  before  directed. 
The  method  of  dialysis  has  been  recommended  by  some 
authorities,  but  we  do  not  consider  it  as  exhaustive  and  re- 
liable as  the  one  just  described. 

Detection  in  the  tissues  and  blood. — Strychnia  is  absorbed 
into  the  circulation,  and  deposited  in  the  various  organs,  just 
like  the  mineral  poisons.  The  rapidity  with  which  the  ab- 
sorption takes  place  is  shown  in  a  case  mentioned  by  Taylor, 
where  a  man  took  five  grains  of  the  poison  by  mistake,  and 
died  in  half  an  hour.  Strychnia  was  discovered  in  the 
stomach  in  the  quantity  of  one  grain ;  it  was  also  detected 
17 


370  TOXICOLOGY. 

in  the  liver  and  the  tongue.  This  case  shows  that  within 
half  an  hour,  four-fifths  of  the  poison  had  been  removed  from  - 
the  stomach  (or  could  not  be  detected  there  by  chemical  re- 
search), and  had  been  diffused  throughout  the  body.  There 
are,  however,  other  cases,  where  the  circumstances  were 
apparently  just  as  favorable  fur  the  absorption  and  diffusion  I 
of  the  poison,  but  where  there  was  a  total  failure  to  detect 
it  in  the  organs,  after  death. 

The  process  is  the  following :  the  organs  are  to  be  finely 
crushed  and  digested  in  strong  alcohol,  acidulated  with  sul- 
phuric acid,  in  the  proportion  of  eight  drops  to  the  fluid 
ounce  of  the  mixture;  this  should  be  heated  below  212°  F. 
for  about  an  hour;  when  cool,  it  is  to  be  filtered  and  con- 
centrated, as  before  directed.  The  residue  is  then  nearly 
neutralized  by  liquor  potassae,  care  being  taken  to  maintain  an 
acid  reaction,  then  filtered,  and  evaporated  nearly  to  dryness. 
To  the  cooled  residue  a  drachm  or  two  of  strong  alcohol  is 
added,  and  thoroughly  stirred  with  it ;  this  dissolves  out  the 
sulphate  of  strychnia,  and  leaves  the  sulphate  of  potassium 
and  the  organic  matters.  The  alcoholic  solution  is  now 
filtered,  evaporated  almost  to  dryness,  the  residue  stirred 
with  pure  water,  rendered  alkaline  by  potassa,  and  finally 
agitated  with  chloroform,  which  deposits  the  alkaloid,  if 
present,  on  evaporation. 

Dr.  Taylor  recommends  acetic,  instead  of  sulphuric,  acid; 
and  ammonia  instead  of  potassa,  in  these  cases. 

The  method  of  Rodgers  and  Girdwood  is  somewhat  sim- 
ilar, and  they  employ  hydrochloric  acid  and  ammonia  as  the 
reagents,  along  with  chloroform. 

Strychnia  may  be  recovered  from  the  blood  by  a  similar 
process.  In  some  experiments  of  Dr.  Wormley,  he  detected 
the  poison  in  the  blood  of  dogs  and  cats,  where  death  took 
place  in  three  and  six  minutes  respectively  after  its  admin- 


POISONING    BY    BRUCIA.  371 

istration.  This  shows  the  extreme  rapidity  with  which  it 
is  absorbed. 

Detection  in  the  urine. — The  urine  should  be  evaporated 
to  a  syrupy  consistence,  acidulated  with  acetic  acid,  mixed 
with  an  ounce  of  strong  alcohol,  filtered,  and  evaporated  to 
near  dryness.  The  residue  is  to  be  stirred  with  pure  water, 
filtered,  if  necessary,  liquor  potassae  added  in  excess,  and 
agitated  with  chloroform. 

Failure  to  detect. — It  must  be  admitted  that  the  most  care- 
ful analysis  sometimes  fails  to  discover  this  poison  in  the 
body  after  death,  and  that,  too,  where  the  circumstances 
were  apparently  favorable  to  it.  This  failure  may  sometimes 
be  ascribed  to  the  smallness  of  the  dose,  and  again,  possibly, 
to  some  interference  not  well  understood.  Mere  putrefaction 
of  the  body  is  no  obstacle  to  its  detection,  since  it  has  been 
recovered  months  after  death,  and  where  the  body  was  in  an 
advanced  state  of  decomposition.  Christison,  Taylor  and 
other  well-known  authorities  have  at  times  been  foiled  in 
their  efforts.  In  a  case  that  occurred  to  the  author,  some 
years  ago,  when  a  woman  was  poisoned  (as  was  alleged) 
with  six  grains  of  strychnia,  and  where  death  was  postponed 
for  the  unusually  long  period  of  six  hours,  there  was  a  sim- 
ilar failure  to  detect  the  poison  eight  weeks  after  death,  al- 
though the  body  was  well  preserved. 

Brucia. — This  alkaloid  is  generally  found  associated  with 
strychnia.  It  occurs  either  in  the  form  of  a  white  powder, 
or  in  colorless  prismatic  crystals.  It  is  more  soluble  in 
water  and  alcohol  than  strychnia.  It  is  freely  soluble  in 
chloroform  and  alcohol.  It  has  an  intensely  bitter  taste. 
Concentrated  sulphuric  acid  dissolves  it,  giving  a  faint  rose 
coloration.  Nitric  acid  gives  a  characteristic  blood-red 
color. 


372  TOXICOLOGY. 

Its  poisonous  properties  are  similar  to  those  of  strychnia, 
though  less  intense.  As  the  symptoms  of  poisoning  by 
brucia  are  similar  to  those  caused  by  strychnia,  the  toxi- 
cologist  should  guard  against  being  deceived  in  a  medico- 
legal investigation,  in  the  event  of  not  discovering  strychnia 
by  the  usual  color  test.  In  such  a  case,  it  would  always  be 
proper  to  search  for  brucia. 

Tests. — The  characteristic  reagent  is  nitric  acid,  which 
instantly  produces  a  blood-red  color,  with  a  speedy  solution 
of  the  alkaloid.  If  heated,  the  color  changes  to  yellow. 
If,  after  cooling,  a  drop  of  the  solution  of  protocliloride  of 
tin  be  added,  the  color  changes  to  a  beautiful  purple.  The 
somewhat  similar  red  color  produced  on  morphia  by  nitric 
acid  is  not  changed  by  protocliloride  of  tin. 

(2)  Sulphuric  acid  and  nitrate  of  potassium. — Touch  the 
fragment  of  brucia  with  a  drop  of  strong  sulphuric  acid,  a 
faint  rose  color  is  produced ;  then  add  a  small  crystal  of 
nitre,  when  the  color  changes  to  a  deep  orange-red. 

(3)  Ammonia  produces,  with  a  drop  of  brucia-solution,  a 
beautiful  crystallization,  viewed  by  the  microscope.  Other 
tests  of  less  importance  are  sulpho-cyanide  of  potassium, 
bichloride  of  platinum  and  corrosive  sublimate. 

The  frog-test  is  equally  applicable  to  brucia,  allowing  for 
its  comparative  inferiority  in  strength  to  strychnia. 

The  toxicological  examination  for  brucia  is  conducted  in 
the  same  manner  as  described  for  strychnia.  The  ultimate 
extract  is  to  be  tested  by  nitric  acid  and  protochloride  of 
tin.  Brucia  has  been  detected  in  the  blood  of  animals 
poisoned  by  it. 


POISONING    BY    BELLADONNA.  373 


CHAPTER  XXVIII. 

ORDER  III.— CEREBROSPINAL  NEUROTICS. 
(i)  DELIRIANTS. 

This  subdivision  of  Cerebro-spinal  Neurotics  has  received 
the  name  of  Deliriants,  because  of  the  active  delirium  that 
constitutes  one  of  their  prominent  symptoms.  They  also 
produce  other  effects  in  common,  such  as  illusion  of  the 
senses,  dilatation  of  the  pupil,  heat  and  dryness  of  the 
throat,  a  flushed  face,  and  frequently  a  redness  of  the  skin. 
They  all  belong  to  the  same  natural  order  of  plants,  Sola- 
nacecz.  From  their  physiological  property  of  dilating  the 
pupil,  they  have  received  the  name  of  Mydriatics.  They 
comprise  Belladonna,  Stramonium,  Hyoscyamus,  and  dif- 
ferent species  of  Solanum. 

SECTION  I. 
POISONING  BY  BELLADONNA— ATROPIA. 

SYMPTOMS. — ATROPIA. — FATAL  DOSE. — TREATMENT. — POST-MORTEM 
APPEARANCES. — CHEMICAL  ANALYSIS. — TOXICOLOGICAL  EXAMINA- 
TION. 

Belladonna  (Deadly  Nightshade). — The  leaves,  berries 
and  root  of  Atropa  Belladonna  are  violently  poisonous.  The 
leaves  and  root -are  used  in  medicine.  Children  are  fre- 
quently poisoned  by  eating  the  berries. 

Symptoms. — A  sense  of  heat  and  dryness  in  the  mouth 
and  throat,  difficulty  of  swallowing,  nausea,  vomiting,  giddi- 
ness, extreme  dilatation  of  the  pupil,  loss  of  vision,  flushed 
face,  sparkling  eyes,  delirium  of  an  excited,  maniacal  char- 


374  TOXICOLOGY. 

acter,  spectral  illusions,  convulsions,  followed  by  stupor  and 
coma.  Irritation  of  the  urinary  organs  frequently  occurs,  such 
as  strangury,  suppression  of  urine  and  hematuria.  A  scarlet 
eruption  is  often  observed  over  the  skin.  Some  of  these 
effects  have  been  produced  by  the  external  application  of 
belladonna,  in  the  form  of  a  plaster  or  liniment.  The 
symptoms  of  belladonna-poisoning  usually  show  themselves 
from  half  an  hour  to  two  hours,  occasionally  sooner.  They 
do  not  generally  terminate  fatally.  Death,  when  it  occurs, 
usually  takes  place  within  twenty-four  hours. 

In  case  of  death  from  the  leaves  or  seeds  of  belladonna, 
these  can  usually  be  distinguished  in  the  alimentary  canal, 
by  their  botanical  characters. 

Atropia. — This  alkaloid  is  the  active  principle  of  bella- 
donna, and  is  a  very  active  poison,  producing  symptoms 
similar  to  those  above  described,  only  more  speedily.  The 
application  of  a  weak  solution  to  the  eyes  has  occasioned 
symptoms  of  belladonna-poisoning.  Used  hypodermically, 
even  in  doses  of  one-fiftieth  to  one-tenth  of  a  grain,  it  occa- 
sions, at  times,  violent  symptoms.  Employed  in  this  man- 
ner in  combination  with  morphia  in  excess,  its  activity 
appears  to  be  modified.  Death  has  resulted  from  the  ex- 
ternal use  of  a  strong  ointment  of  atropia. 

Fatal  dose. — One-half  to  three-quarters  of  a  grain  may  be 
regarded  as  a  minimum  fatal  dose  for  an  adult.  The  crim- 
inal administration  of  this  poison  is  very  rare.  Dr.  Taylor 
records  a  case  where  a  surgeon  of  a  workhouse  was  fatally 
poisoned  by  a  nurse,  by  administering  it  in  milk.  The 
diagnosis  is  not  always  easy,  since  the  same  symptoms  are 
produced  by  hyoscyamus  and  stramonium.  There  appears 
to  be  a  special  tendency  to  its  elimination  from  the  system 
by  the  kidneys.  Prof.  Guy  states,  on  the  authority  of  Dr. 
John  Harley,  that  the  presence  of  atropia  in  the  urine  can 


ATROPIA TESTS.  375 

be  readily  proven  within  twenty  minutes  after  the  injection 
under  the  skin  of  one-forty-eighth  to  one-ninety-sixth  of  a 
grain,  by  the  action  of  the  urine  on  the  eye.  Twelve  drops 
will  largely  dilate  the  pupil,  and  maintain  it  in  that  state 
for  several  hours  (Foren.  Med.,  p.  512). 

Treatment. — The  immediate  evacuation  of  the  stomach 
by  an  active  emetic,  or  by  the  stomach-pump.  There  is  no 
chemical  antidote.  The  physiological  antidote  is  morphia, 
which  should  be  carefully  and  repeatedly  administered  (via1, 
ante  p.  334). 

Post-mortem  appearances. — These  are  not  characteristic. 
There  may  be  congestion  of  the  vessels  of  the  brain,  with 
some  red  patches  of  the  stomach  and  oesophagus.  When 
the  poisoning  has  resulted  from  eating  the  ripe  berries,  the 
whole  lining  membrane  of  the  alimentary  canal  may  be 
dyed  of  a  purple  color,  and  portions  of  the  berries  and  seeds 
may  be  discovered  in  the  intestines,  or  in  the  stools.  The 
blood  is  usually  fluid,  and  dark-colored. 

Chemical  analysis. — Atropia,  when  pure,  occurs  in  white 
crystalline  tufts.  Its  taste  is  acrid  and  bitter ;  slightly 
soluble  in  cold  water,  very  soluble  in  alcohol,  ether  and 
chloroform.  It  sublimes  at  200°  F.  Its  color  is  not 
changed  by  either  of  the  mineral  acids.  It  has  alkaline 
properties,  neutralizing  acids,  and  forming  salts. 

The  alkalies  throw  down  a  precipitate  from  a  salt  of 
atropia,  which  ultimately  becomes  crystalline.  That  pro- 
duced by  ammonia  remains  amorphous.  It  is  also  precipi- 
tated by  chloride  of  gold,  and  by  carb  azotic  acid.  Worm  ley 
considers  bromine  in  hydrobromic  acid  to  be  the  character- 
istic test  for  atropia.  The  precipitate  is  at  first  amorphous, 
of  a  yellow  color;  but  it  soon  becomes  crystalline.  It  is 
insoluble  in  acetic  acid,  and  but  slightly  so  in  either  of  the 
mineral  acids.     The  one-ten-thousandth,  to  one-twenty-five 


376  TOXICOLOGY. 

thousandth  of  a  grain  will  give  satisfactory  results  with  this 
reagent  (Micro-  Chan,  of  Poisons,  p.  631). 

Toxicological  examination. — We  should  first  of  all  en- 
deavor to  discover  any  seeds,  or  remains  of  the  leaves  or 
berries  of  the  plant.  The  vomit  and  stools  should,  if 
possible,  be  also  examined  for  these.  The  stomach,  with 
its  contents,  and  other  organs,  properly  comminuted,  should 
be  treated  after  a  modification  of  Stas'  process,  alcohol 
being  used  as  the  solvent,  along  with  sulphuric  acid.  After 
heating,  straining,  evaporating,  purifying  by  pure  ether,  re- 
moving the  ether,  and  adding  solution  of  potassa  in  excess, 
the  ultimate  extract  is  obtained  by  chloroform  and  tested, 
first,  with  the  bromine -test,  which,  if  successful,  may  be 
followed  by  the  other  tests. 

The  physiological  test  consists  in  applying  a  portion  of  the 
ultimate  extract  to  the  eyes  either  of  a  man,  or  one  of  the 
lower  animals,  as  the  rabbit.  The  minutest  quantity  will 
produce  the  characteristic  dilatation  of  the  pupil.  It  must, 
however,  be  remembered  that  other  members  of  this  class 
of  vegetables  will  produce  a  similar  result. 

The  rabbit  evinces  a  remarkable  tolerance  for  belladonna 
and  its  alkaloid.  It  will  live  exclusively  on  the  former  for 
many  days,  and  tolerate  enormous  doses  of  the  latter,  either 
by  the  stomach  or  subcutaneously,  without  perceptible 
effects. 

SECTION  11. 
TOISONING  BY  STRAMONIUM,  HYOSCYAMUS  AND   SOLANUM. 

Stramonium  (Thorn  Apple,  Jamestozvn  Weed). — The  Da- 
tura stramonium  is  a  very  common  plant,  abounding  in  this 
country,  and  also  in  Europe.  It  grows  freely  on  waste 
grounds ;  other  varieties  occur  in  India.  All  parts  of  the 
plant  are  poisonous,  especially  the  seeds  and  fruit.  Its 
active  alkaloid  principle  is  named  daturia. 


POISONING   BY    HYOSCYAMUS.  377 

Cases  of  poisoning  by  stramonium  are  usually  accidental, 
and  chiefly  occur  in  children,  from  eating  the  seeds. 

Symptoms. — Very  similar  to  those  produced  by  bella- 
donna, such  as  dryness  of  throat,  with  difficulty  of  swal- 
lowing, dilated,  insensible  pupil,  violent  and  incoherent 
delirium,  nausea,  vomiting,  headache,  vertigo,  ringing  in 
the  ears,  spectral  illusions,  followed  by  stupor  and  coma. 
Sometimes  there  are  convulsions  and  paralysis,  together 
with  a  scarlet  efflorescence  on  the  skin.  The  external  appli- 
cation of  the  bruised  leaves  has  occasioned  symptoms  of 
poisoning. 

In  India,  the  Datura  is  employed  by  the  Thugs  for  the 
purpose  of  drugging  their  victims. 

Post-mortem  appearances. — Very  similar  to  those  result- 
ing from  belladonna.  There  is  nothing  characteristic.  The 
seeds  and  remains  of  the  leaves  may  be  discovered  in  the 
alimentary  canal,  if  these  have  been  the  cause  of  death. 

Treatment. — The  same  as  that  recommended  for  bella- 
donna poisoning. 

Analysis. — The  seeds  are  of  a  black  or  brown  color, 
kidney-shaped,  with  a  wrinkled  surface.  They  are  much 
larger  than  those  of  belladonna  or  hyoscyamus.  According 
to  Prof.  Guy,  it  requires  one  hundred  and  twenty  henbane 
seeds,  and  ninety  of  belladonna  to  weigh  one  grain,  but  only 
eight  of  stramonium.  There  is  no  known  test  to  distinguish 
daturia  from  atropia ;  these  two  alkaloids  are  now  generally 
regarded  as  identical. 

The  method  of  procuring  daturia  from  the  stomach  and 
organs  is  the  same  as  that  above  described  for  atropia 
(P-  332). 

Hyoscyamus  {Henbane). — The  Hyoscyamus  niger  grows 
both  in  America  and   Europe.     All    parts    are    poisonous. 

17* 


o<8  TOXICOLOGY. 

The  root  is  tapering,  resembling  that  of  the  parsnip,  for 
which  it  has  often  been  mistaken.  The  medicinal  prepara- 
tions from  the  plant  are  extremely  variable  and  uncertain, 
depending  very  much  on  the  mode  of  growth,  collection 
and  preparation. 

The  symptoms,  in  general,  resemble  those  of  belladonna 
and  stramonium. 

Analysis. — It  can  only  be  identified  in  the  matters  vomited, 
or  in  the  stomach  and  intestines  after  death,  by  the 
botanical  characters  of  the  seeds  or  fragments  of  the  leaves 
discovered. 

Hyoscyamia,  the  active  alkaloidal  principle,  occurs  in 
white,  silky  crystals,  inodorous  when  pure,  but  as  usually 
found,  possessing  a  disagreeable  smell ;  taste  acrid.  It  is 
difficult  to  isolate.  There  is  no  proper  chemical  test  for  it. 
It  dilates  the  pupil,  like  atropia  and  daturia.  It  speedily 
passes  into  the  urine,  when  swallowed. 

Solanum. — Three    species    of   the    genus   Solatium  are 

usually  referred  to  in  the  books,  as  possessing  poisonous 
properties :  these  are  S.  dulcamara,  or  Bittersweet,  or 
Woody  Nightshade;  S.  nigrum,  or  Garden  Nightshade; 
and  5.  tuberosum,  or  common  potato.  These  all  contain  an 
active  alkaloid  principle — Solania. 

The  vS.  dulcamara  is  a  native  of  Great  Britain,  and  is  cul- 
tivated in  our  gardens  as  an  ornament,  for  its  purple  flowers 
and  bright  red  berries.  The  latter  are  frequently  eaten  by 
children,  occasioning  poisonous  results.  The  dried  stems 
are  used  medicinally. 

The  S.  nigrum  produces  white  flowers  and  black  berries. 
The  latter,  like  the  fruit  of  the  S.  dulcamara,  have  frequently 
proved  poisonous  to  children  who  have  swallowed  them. 
They  are  more  powerful  in  their  effects  than  the  others. 


POISONING    BY   SOLANIA.  379 

S.  tuberosum,  or  common  potato. — The  berries  and  young 
shoots  have  proved  poisonous,  the  former  fatally,  in  the  case 
of  a  young  girl  reported  in  the  Lancet,  June,  1858.  Chris- 
tison  quotes  from  Dr.  Kabler,  of  Prague,  an  instance  where 
four  persons  of  a  family  were  seized  with  alarming  symp- 
toms, such  as  vomiting,  coma  and  convulsions,  after  eating 
potatoes  that  had  commenced  to  sprout  and  shrivel. 

The  general  symptoms  produced  by  solania  are  very 
similar  to  those  resulting  from  the  other  mydriatics.  It  is 
much  less  powerful  than  the  other  alkaloids  of  this  class. 

When  pure,  solania  is  in  the  form  of  delicate  acicular 
crystals ;  nearly  insoluble  in  water,  soluble  in  alcohol,  less 
so  in  ether,  insoluble  in  chloroform.  It  is  also  soluble  in 
amylic  alcohol.  Cold  sulphuric  acid  first  changes  it  to  an 
orange-yellow,  and  then  dissolves  it,  the  solution  becoming 
brown.  Nitric  acid  dissolves  it,  the  solution  being  at  first 
colorless,  and  subsequently  changing  to  a  rose-red  tint. 
The  former  acid  is  the  best  test  for  it.  Other  reagents  do 
not  give  characteristic  results. 

Solania  is  separated  from  organic  mixtures  by  a  modifica- 
tion of  Stas'  process  ;  alcohol  and  sulphuric  acid  being  em- 
ployed as  the  solvent,  and  warm  alcohol  to  separate  the 
final  extract. 


380  TOXICOLOGY. 


CHAPTER   XXIX. 

(2)  DEPRESSANTS. 

Under  this  subdivision  of  Cerebro-spinal  Neurotics,  are 
conveniently  included  several  active  poisons,  which  agree 
in  the  property  of  causing  great  depression  of  the  muscular 
system,  although  in  some  other  respects  they  may  differ 
from  one  another.  By  thus  grouping  them  together,  it  is 
not  intended  to  imply  that  they  all  produce  the  same  phy- 
siological effects. 

SECTION  I. 
POISONING   BY   TOBACCO   AND    LOBELIA. 

EFFECTS  OF  TOBACCO— POST-MORTEM  LESIONS — NICOTINA — PROPER- 
TIES—  CHEMICAL  REACTIONS — TOXICOLOGICAL  EXAMINATION — 
LOBELIA. 

Tobacco. — The  dried  leaves  of  Nicotiana  tabaaim,  a  plant 
belonging  to  the  natural  order  of  Solanacea?.  It  owes  its 
activity  and  poisonous  properties  to  a  volatile,  liquid  alka- 
loid, of  an  oily  consistence,  named  ?iicotina,  which  some- 
what resembles  conia,  and  which  exists  in  different  propor- 
tions in  different  specimens  of  the  leaves,  varying  from  two 
to  eight  per  cent. 

Symptoms. — A  large  dose  of  tobacco  (or  even  a  small 
one  to  those  unaccustomed  to  its  use)  produces  very  decided 
symptoms.  Very  soon  after  taking  it,  either  by  swallowing 
or  by  enema,  it  occasions  nausea,  giddiness,  a  sense  of  con- 
fusion of  the  head,  vomiting,  severe  retching,  great  prostra- 
tion, heat  in  the  stomach,  frequent  and  very  feeble  pulse, 
cold,  clammy  skin,  trembling  of  the  limbs,  and  sometimes 
severe  purging.     Respiration  is  difficult,  and  urination  invol- 


POISONING    BY    TOBACCO.  381 

untary.  In  some  cases,  there  is  violent  pain  in  the  abdo- 
men ;  in  others,  there  is  great  sense  of  depression,  and  of 
impending  death.  The  pupils  are  not  always  similarly 
affected.  Taylor  states  that  they  are  dilated.  Percival 
speaks  of  it  as  differing  from  belladonna  in  contracting 
them;  also  by  the  absence  of  delirium,  and  of  dryness  of  the 
throat.  Wharton  and  Stille  {Med.  Jurisp.f  1873,  II,  p.  609) 
state  that  the  pupils  are  but  slightly  affected. 

The  external  application  of  tobacco,  either  to  the  sound 
skin,  or  to  abraded  surfaces,  produces  alarming,  and  even 
fatal  effects.  A  wet  leaf  put  around  the  throat  in  spasmodic 
croup  often  relieves  the  spasm,  but  it  should  be  used  with 
great  caution  on  a  young  child.  A  decoction  applied  to  the 
skin  of  a  man  for  an  eruptive  disease,  caused  death  in  three 
hours  (Am.  Jour.  Med.  Sei.f  January,  1865). 

Its  fatal  effects,  when  administered  by  the  rectum,  are 
well  known.  It  was  formerly  much  used  in  this  manner, 
to  aid  the  taxis  in  strangulated  hernia ;  but  it  is  always  a 
dangerous  remedy.  Even  tobacco  smoke,  diffused  through 
water  and  swallowed,  has  caused  the  death  of  a  young 
infant. 

Tobacco  smoking  has  been  known  to  produce  violent  and 
even  fatal  effects,  when  carried  to  great  excess,  although 
there  is  considerable  diversity  of  opinion  as  to  whether 
nicotin  is  present  in  tobacco  smoke,  or  not.  Respectable 
authorities  are  found  on  both  sides. 

The  rapidity  of  the  effects  of  tobacco  on  the  human 
system  varies  with  the  dose,  and  mode  of  administration. 
In  one  case,  snuff  swallowed  in  whiskey  caused  death  in 
one  hour.  In  another  instance,  quoted  by  Beck,  an  enema 
of  tobacco,  used  to  expel  worms,  produced  violent  convul- 
sions and  death  in  fifteen  minutes.  Christison  gives  another 
case,  where   a   tobacco    enema   proved   fatal   in  thirty-five 


382  TOXICOLOGY. 

minutes.  The  application  of  nicotina  to  the  tongue  of  an 
animal  caused  death  within  two  minutes. 

Post-mortem  appearances. — There  is  no  characteristic 
lesion.  A  diffused  redness  over  the  mucous  surface  of  the 
stomach  and  bowels,  with  an  empty  heart,  and  congestion 
of  the  vessels  of  the  brain,  liver  and  lungs,  are  about  all 
that  will  be  found.  The  blood  is  usually  very  dark  and 
liquid.  If  the  leaf  or  powder  has  been  swallowed,  these 
may  be  recognized  by  microscopic  examination.  In  a  case 
of  suicidal  death,  examined  by  Dr.  Taylor,  there  were  gen- 
eral relaxation  of  the  muscular  system,  staring  eyes,  bloated 
and  livid  features,  the  vessels  of  the  brain  and  scalp,  and 
also  of  the  lungs,  gorged  with  black  blood,  and  the  heart 
empty,  except  its  left  auricle.  There  was  intense  conges- 
tion of  the  mucous  membrane  of  the  stomach  and  of  the 
liver.  The  blood  was  black  and  liquid,  and  in  some  parts 
had  the  consistence  of  treacle.  No  peculiar  odor  was  per- 
ceptible {On  Poisons,  p.  66 1). 

Nicotina. — This  alkaloid,  when  pure,  is  a  colorless,  oily 
liquid,  which,  on  exposure,  becomes  light  yellowish,  and 
thicker  in  consistence.  It  produces  a  greasy,  volatile  stain 
on  paper,  like  conia.  It  is  usually  said  to  possess  an  acrid, 
unpleasant  odor,  but,  if  perfectly  pure,  the  smell  is  ethereal 
and  agreeable.  It  has  a  strong,  alkaline  reaction,  and  a 
density  of  1.048.  It  is  freely  soluble  in  water,  alcohol, 
ether,  chloroform,  turpentine,  and  the  fixed  oils.  Ether  and 
chloroform  will  extract  it  from  its  watery  solution.  Its  taste 
is  very  pungent  and  acrid,  even  when  much  diluted,  causing 
a  peculiar  sensation  in  the  throat  and  air  passages.  It 
slowly  distills  at  about  295 °  F.,  and  boils  at  about  4700  F. 
Heated  on  platinum,  it  burns  with  a  bright  flame,  emitting 
a  thick  black  smoke. 

Nicotina  is  one  of  the  most  rapidly  fatal  poisons  known, 


NICOTINA — CHEMICAL    REACTIONS.  383 

even  rivaling  prussic  acid.  A  single  drop  destroyed  a  rabbit 
in  three  and  a  half  minutes.  In  Wormley's  experiments, 
one  drop,  placed  in  the  mouth  of  a  full-grown  cat,  produced 
immediate  prostration,  continued  convulsions,  and  death  in 
seventy-eight  seconds. 

In  the  celebrated  case  of  Connt  Bocarme,  who  was  exe- 
cuted in  Belgium,  in  1 851,  for  poisoning  his  brother-in-law, 
Gustave  Fougnies,  nicotina  was  the  agent  used.  An  un- 
known quantity  was  forcibly  put  into  the  throat  of  the 
victim,  the  Countess  assisting  her  husband  as  an  accomplice 
in  the  murder.  Death  was  believed  to  have  taken  place 
within  five  minutes.  The  poison  was  detected  by  M.  Stas 
in  the  tongue,  throat,  stomach,  liver  and  spleen  of  the 
deceased,  and  also  from  stains  on  the  floor,  near  where  the 
act  was  committed.  From  the  excellent  report  of  the  ex- 
amination of  M.  Stas,  we  may  note  the  following  particulars  : 
The  appearance  of  the  tongue  indicated  the  action  of  some 
highly  acrid  agent ;  it  was  swollen,  blackened,  softened  and 
friable;  the  epithelium  was  easily  detached.  This  was  also 
the  condition  of  the  mucous  lining  of  the  mouth  and 
pharynx ;  it  was  reddened,  as  if  cauterized,  and  easily  sepa- 
rated. The  lining  membrane  of  the  stomach  was  intensely 
injected,  exhibiting  large  patches,  which  were  livid  and 
black.  The  vessels  were  filled  with  a  black  coagulum, 
resembling  blood  that  had  been  treated  with  sulphuric  acid. 
The  duodenum  was  also  highly  injected.  There  were  no 
ulcerations  or  perforations  of  the  stomach  and  bowels.  The 
lungs  were  gorged  with  black  blood,  and  exhibited  the  usual 
character  of  asphyxia.  The  heart  was  normal,  its  cavities 
contained  black,  liquid  blood.  No  odor  was  observed  in  the 
body  (Orji/a,  Toxicol.,  II,  p.  498). 

Chemical  reactions. — If  a  drop  be  put  into  a  watch  glass, 
and  this  be  covered  with  another  glass,  inverted,  containing 


384  TOXICOLOGY. 

a  drop  of  either  nitric  or  hydrochloric  acid,  the  glass  will 
become  filled  with  white  fumes,  not  so  dense  as  from  conia, 
nor  do  they  give  rise  to  the  formation  of  crystals.  The 
strong  acids  applied  directly  to  it  produce  no  characteristic 
effects. 

Nicotina  unites  freely  with  acids,  forming  salts,  which 
retain  the  peculiar  taste  of  the  alkaloid,  but  are  destitute  of 
odor.  They  are  mostly  soluble  in  water  and  alcohol,  but 
not  in  ether  or  chloroform. 

(i)  Bichloride  of  platinum  throws  down  a  yellow  precipi- 
tate, which  becomes  crystalline,  seen  under  the  microscope, 
which  is  soluble  in  hydrochloric  acid.  (No  precipitate  is 
caused  by  conia.) 

(2)  Corrosive  sublimate  gives  a  white  crystalline  precipi- 
tate, changing  to  yellow.  These  crystals  assume  a  peculiar, 
beautiful  appearance,  in  groups  of  various  patterns.  These 
are  distinguished  from  the  precipitates  caused  by  this  same 
reagent  with  ammonia  and  the  other  alkaloids,  by  the  fact 
that  the  latter  are  amorphous,  except  that  of  strychnia,  but 
which  last  is  wholly  unlike  that  produced  by  nicotina.  This 
is  a  very  delicate  test. 

(3)  Terchloride  of  gold  yields  a  yellow  amorphous  pre- 
cipitate, but  not  characteristic.  The  same  is  true  of  iodide 
of  potassium,  and  of  bromine  in  hydrobromic  acid. 

(4)  Carbazotic  acid  gives  a  yellow,  amorphous  precipitate, 
which  ultimately  assumes  the  form  of  a  crystalline  tuft,  to  be 
viewed  by  the  microscope. 

Toxicological  examination. — The  stomach  and  other  organs, 
properly  prepared,  may  be  subjected  to  the  process  of  Stas. 
In  fact,  it  was  the  very  process  employed  by  its  originator 
in  the  Bocarme  case  above  alluded  to.  Other  good  authori- 
ties have  somewhat  simplified  his  process.  Water  may  be 
employed  as  the  solvent,  instead   of  alcohol;    and    either 


POISONING    BY    LOBELIA SYMPTOMS.  385 

acetic,  sulphuric,  or  tartaric  acid  may  be  used.  After  proper 
concentration  and  filtration,  it  should  be  supersaturated 
with  potash  or  soda,  and  shaken  up  with  chloroform  or 
ether,  and  these  solutions,  when  properly  separated,  allowed 
to  evaporate  spontaneously  on  watch  crystals,  when  the 
nicotina,  if  present,  will  be  seen  in  the  form  of  drops  or 
oily  streaks,  having  the  peculiar  odor  of  the  alkaloid,  which 
is  rendered  more  distinct  by  heating.  This  should  be  dis- 
solved in  a  few  drops  of  water,  and  the  appropriate  tests 
applied.  A  drop  or  two  may  also  be  given  to  a  small 
animal.  Nicotina  inserted  under  the  skin  of  a  frog  pro- 
duces peculiar  muscular  movements,  slowing  of  the  heart's 
action  and  of  respiration. 

Lobelia. — The  Lobelia  inflata,  or  Indian  tobacco,  is  a 
native  of  this  country,  belonging  to  the  natural  order 
Lobcliacece.  It  is  extensively  used  both  here  and  in  Great 
Britain  as  the  standard  remedy  of  the  Thomsonian  or  Botani- 
cal Doctors.  According  to  Dr.  Letheby,  thirteen  cases  of 
poisoning  by  this  substance  had  occurred  in  England  within 
three  or  four  years,  and  Dr.  Beck  states  that  "  thousands  of 
individuals  in  the  United  States  have  been  murdered  by  the 
combined  use  of  capsicum  and  lobelia,  administered  by 
the  Thomsonian  quacks"  {Med.  Jnrisp.,  II,  p.  736).  The 
leaves  and  seeds  are  the  parts  employed.  They  owe  their 
activity  to  a  fixed  alkaloid  named  lobelina. 

Symptoms. — In  small  doses  lobelia  acts  as  an  expectorant  ; 
in  large  doses,  as  an  emetic  and  depressant.  In  poisonous 
doses  it  produces  distressing  nausea  and  vomiting,  some- 
times purging,  extreme  relaxation,  cold  sweats,  small,  feeble 
pulse,  great  prostration,  contracted  pupils,  stupor,  occasion- 
ally convulsions,  coma  and  death — symptoms  strikingly  like 


386  TOXICOLOGY. 

those  caused  by  tobacco.  A  drachm  of  the  powdered 
leaves  has  proved  fatal. 

The  post-mortem  appearances  are  very  similar  to  those 
caused  by  tobacco. 

Lobelina,  the  active  alkaloid  principle,  is  a  yellowish 
liquid,  lighter  than  water,  of  a  somewhat  aromatic  odor,  and 
acrid,  persistent  taste  ;  soluble  in  water,  more  so  in  alcohol 
and  ether ;  has  an  alkaline  reaction,  forming  soluble  salts, 
with  acids.  Tannic  acid  precipitates  it  from  its  solutions. 
It  resembles  nicotina  in  most  of  its  properties.  On  animals, 
lobelina  seems  to  produce  the  narcotic,  but  not  the  emetic 
effects  of  the  plant. 

No  case  is  recorded  of  death  from  lobelina.  In  the  in- 
vestigation of  a  case  of  death  from  lobelia,  the  diagnosis 
would  be  materially  aided  by  the  discovery  of  fragments  of 
the  leaves,  or  of  the  seeds.  (For  the  report  of  two  interest- 
ing trials  for  fatal  poisoning  by  lobelia,  under  the  "botanical 
treatment,"  see  Wharton  &  Stille's  Mcd.Jurisp.,  1873,  II,  pp. 
586  and  963.) 

SECTION  11. 
POISOXIXG  BY  HEMLOCK— CONIA. 

SYMPTOMS. —  POST-MORTEM  APPEARANCES. —  CONTA. CHEMICAL  RE- 
ACTION'S.— TOXICOLOGICAL  EXAMINATION.- — OTHER  POISONOUS  HEM- 
LOCKS. 

The  Conium  maculatum,  or  Spotted  Hemlock  of  Great 
Britain  and  America,  is  believed  to  be  the  same  plant  as 
the  Cicuta  of  the  ancient  Greeks,  the  one  that  furnished  the 
celebrated  State  poison  by  which  Socrates  perished.  It  be- 
longs to  the  natural  order  Umbellifcrcz,  which  also  includes 
many  other  poisonous  plants.  All  parts  of  this  plant  are 
poisonous  ;  the  leaves  and  root  are  employed  in  medicine, 
in  the  form  of  fresh  juice  and  extract. 


POISONING    BY   CONIA.  387 

Poisoning  by  hemlock  is  generally  the  result  of  accident, 
the  fresh  leaves  being  used  in  soup  in  mistake  for  parsley, 
which  it  somewhat  resembles.  Its  action  on  man  appears 
to  be  very  variable — at  least  the  different  accounts  are  very 
diverse. 

Symptoms. — Headache,  imperfect  vision,  dilated  pupils, 
difficulty  of  swallowing,  drowsiness,  a  tingling  sensation 
along  the  muscles,  gradually  complete  paralysis  of  the  ex- 
tremities; this  extends  finally  to  the  muscles  of  respiration, 
and  the  patient  dies,  at  last,  from  apncea.  If  death  be  de- 
layed for  some  time,  there  may  be  convulsions,  coma,  violent 
delirium,  accompanied  with  salivation,  and  involuntary  dis- 
charges from  the  bladder  and  bowels.  Death  usually  takes 
place  in  one  to  three  hours.  One  drop  of  conia  is  considered 
to  be  a  poisonous  dose.  The  treatment  consists  in  a  prompt 
evacuation  of  the  stomach  by  emetics,  or,  the  use  of  the 
stomach  pump,  followed  by  castor  oil  and  stimulants. 

Post-mortem  appearances. — These  are  not  at  all  character- 
istic; redness  of  the  mucous  membrane  of  the  stomach  and 
congestion  of  the  lungs  being  usually  observed.  Fragments 
of  the  leaves  and  the  seeds  (if  these  have  been  swallowed) 
may  often  be  recognized  in  the  stomach  and  bowels,  with 
the  aid  of  the  microscope.  If  the  leaves  be  rubbed  in  a 
mortar  with  liquor  potassae,  they  emit  a  peculiar  mousy  odor. 

Conia. — This  alkaloid  exists  most  abundantly  in  the  seeds. 
It  is  one  of  the  most  powerful  and  fatal  poisons  known. 
Christison  states  that  a  single  drop,  applied  to  the  eye  of  a 
rabbit,  killed  it  in  nine  minutes ;  and  three  drops,  applied  in 
the  same  manner,  killed  a  strong  cat  in  a  minute  and  a  half. 
In  Wormley's  experiments,  a  single  drop  placed  upon  the 
tongue  of  a  large  cat,  caused  the  animal  at  first  to  stand 
still ;  in  two  minutes  and  a  half  it  fell  upon  its  side,  voided 
urine,  had  violent  convulsions  of  the  limbs,  with  trembling 


388  TOXICOLOGY. 

of  the  body,  when  it  died  in  three  and  a  half  minutes  from 
the  time  of  administration. 

Treatment. — Prompt  emesis,  to  get  rid  of  the  poison,  and 
active  stimulation.  Strychnia  has  been  suggested  as  a  phy- 
siological antidote,  but  it  is  too  dangerous  a  substance  to 
deserve  to  be  employed  for  this  purpose. 

Chemical  properties. — When  pure  it  is  a  colorless,  vola- 
tile, oily  liquid ;  the  odor  is  peculiar,  repulsive  and  suffoca- 
tive, resembling  that  of  a  stale  tobacco  pipe.  Diluted  with 
water,  it  emits  an  odor  resembling  mice.  It  gives  a  greasy 
stain  to  paper,  burns  with  a  bright,  smoky  flame  ;  taste  dis- 
agreeable and  permanent.  Exposed  to  the  air,  it  becomes 
yellowish  and  resinoid.  It  is  partially  soluble  in  water, 
freely  so  in  alcohol,  ether  and  chloroform ;  the  two  latter 
will  separate  it  from  its  aqueous  solutions. 

Tests. — A  drop  is  placed  in  a  watch  glass,  and  covered 
over  with  a  precisely  similar  glass,  holding  a  drop  of  pure 
hydrochloric  acid  on  its  under  surface  ;  both  glasses  imme- 
diately become  filled  with  dense  white  fumes,  and  the  drop 
of  conia  is  converted  into  a  mass  of  beautiful,  delicate  crys- 
talline needles,  which  do  not  deliquesce  in  the  air.  Sul- 
phuric acid  imparts  to  it  a  pale  red  color.  Nitric  acid 
causes  with  it  dense  white  fumes.  Strong  hydrochloric 
acid  imparts  to  it  a  faint  tint,  which  gradually  becomes  much 
deeper,  and  on  evaporation,  needle-shaped  crystals  appear. 
Like  the  fixed  alkaloids,  it  yields  precipitates  with  tannic 
acid,  corrosive  sublimate,  terchloride  of  gold,  bichloride  of 
platinum,  iodide  of  potassium,  etc.  Its  liquid,  oily  condi- 
tion, together  with  its  peculiar  odor,  will  distinguish  it  from 
all  other  bodies  except  nicotina  ;  and  the  points  of  differ- 
ence between  the  two  are  mentioned  under  the  head  of 
Nicotina  (p.  383). 

Toxicological  examination. — Search  first  for  any  remains 


POISONING    BY    CONIA.  389 

of  leaves,  or  of  seeds,  in  the  stomach  and  intestines,  and 
avoid  mistaking  the  leaves  of  parsley  for  those  of  hemlock. 
Rub  the  leaves  in  a  mortar,  with  potassa,  to  develop  the 
peculiar  mousy  smell.  Then  distill,  and  examine  the  dis- 
tillate before  employing  the  more  elaborate  process  of  Stas. 
Water  and  acetic  acid  may  be  employed  as  the  proper  sol- 
vents ;  evaporate  the  filtered  solution  to  a  syrupy  consist- 
ence, mix  with  strong  alcohol  and  a  few  drops  of  acetic 
acid,  filter  again  and  evaporate  to  near  dryness ;  add  a  little 
distilled  water,  supersaturate  with  solution  of  potassa,  and 
agitate  with  ether,  repeating  the  process  several  times.  Re- 
move the  ether,  and  allow  it  to  evaporate  spontaneously. 
Dilute  the  alkaloid,  and  subject  it  to  the  appropriate  tests. 
The  toxicologist  should  guard  against  too  strong  a  re- 
liance upon  the  supposed  odor  of  conia.  Dr.  Harley  justly 
observes  that  potassa  may  often  develop  an  odor  from  or- 
ganic substances  which  might  possibly  be  mistaken  for  that 
of  conia,  when  the  latter  was  not  present.  Nothing  short 
of  the  isolation  of  this  principle,  in  a  search  for  the  poison, 
should  satisfy  us. 

The  other  hemlocks,  viz.,  Cicuta  virosa,  or  water  hemlock, 
CEnanthe  crocata,  or  hemlock  water-dropwort,  and  sEtliusa 
cynapium,  or  Fool's  parsley,  or  lesser  hemlock,  are  all  very 
poisonous ;  this  is  especially  true  of  the  QiuantJie,  which  is 
one  of  the  most  poisonous  of  the  umbelliferae. 


390  TOXICOLOGY. 

SECTION   III. 

POISONING  BY  ACONITE  AND  CALABAR  BEAN. 

PROPERTIES  OF  THE  PLANT. —  EFFECTS. —  POST-MORTEM  APPEAR- 
ANCES. —  ACONITINE. —  FATAL  DOSE.  —  TREATMENT.  —  CHEMICAL 
ANALYSIS.  —  TOXICOLOGICAL  EXAMINATION.  —  CALABAR  BEAN.  — 
ESERINE. 

Aconite.  —  The  Aconitum  napellus  (Monkshood,  or 
Wolfsbane)  is  indigenous  in  Europe,  but  is  cultivated  in  this 
country.  It  grows  from  two  to  four  or  five  feet  high,  and 
has  a  spike  of  rich  blue  flowers.  All  parts  of  it  are  poison- 
ous, the. root  most  so,  depending  on  the  presence  of  the 
alkaloid  aconitia  or  aconitine.  The  root  is  tapering,  carrot- 
like, two  or  three  inches  long,  having  a  number  of  curly 
fibres  passing  off  from  it.  This  root  has  frequently  been 
mistaken  for  the  root  of  the  horse-radish,  from  which,  how- 
ever, it  differs  essentially  in  appearance;  the  latter  being  long 
and  cylindrical  and  truncated,  not  tapering,  of  a  light 
brown  color  externally,  white  internally,  and  of  a  sweetish, 
hot  and  pungent  taste,  totally  distinct  from  that  of  aconite, 
which  imparts  to  the  lips,  tongue  and  fauces  a  peculiar 
tingling,  numbing  sensation,  which  is  very  persistent. 

There  is  considerable  diversity  in  the  activity  of  different 
specimens  of  aconite,  depending,  doubtless,  on  the  time  and 
modes  of  collecting  and  drying  of  the  plant,  and  probably 
also  on  the  place  of  growth.  This  may  account  for  the  dis- 
cordant results  obtained  by  different  investigators. 

Aconite  root  has  been  administered  criminally  in  at  least 
one  recorded  case,  where  the  powdered  root  was  mixed 
with  pepper,  and  sprinkled  over  the  greens  used  for  dinner 
by  the  deceased  {Dub.  Jour. ,  July,  1841). 

Symptoms. — On  animals,  according  to  Dr.  Fleming,  there 
are  weakness  of  the  limbs  and  staggering,  respiration  slow 
and  labored,  paralysis,  loss  of  sensation,  increased  difficulty 


POISONING    BY    ACONITE FATAL    DOSE.  o(Jl 

of  breathing,  and  after  a  few  spasmodic  twitches,  death  by 
asphyxia.  In  a  few  instances  there  were  decided  convul- 
sions, and  even  opisthotonos.  The  pupils  were  generally 
contracted.  The  heart  continued  beating  after  death.  There 
was  great  congestion  of  the  venous  system,  with  distention 
of  the  right  side  of  the  heart. 

On  i}ian. — There  is  first  a  dryness  of  the  throat,  accom- 
panied with  tingling  and  numbness  of  the  lips,  throat  and 
tongue,  followed  by  nausea  and  vomiting,  with  pain  and 
tenderness  of  the  epigastrium.  The  numbness  and  tingling 
now  become  more  general,  with  diminution  or  loss  of  sensi- 
bility of  the  surface,  vertigo,  dimness  of  vision,  tinnitus 
aurium,  with  occasional  deafness,  frothing  at  the  mouth, 
sense  of  constriction  of  the  throat,  great  muscular  prostra- 
tion, inability  to  walk,  a  slow,  feeble  pulse,  difficulty  of 
breathing,  a  cold,  clammy  skin,  dilated  pupils,  features  pale, 
perhaps  a  few  convulsions,  followed  by  death.  The  mind 
usually  remains  clear  to  the  last.  Delirium  is  rare.  Death 
is  apt  to  be  sudden,  either  from  shock,  asphyxia,  or  syncope. 

Post-mortem  appearances. — There  is  nothing  character- 
istic. There  is  usually  general  venous  congestion  of  all  the 
organs,  especially  the  brain,  lungs  and  liver.  There  maybe 
redness  of  the  lining  membrane  of  the  stomach.  The  blood 
is  generally  fluid,  and  dark  in  color.  The  heart  may  con- 
tinue beating  for  a  little  while  after  death,  indicating  that 
this  was  caused  by  asphyxia.  In  other  cases,  the  death 
may  be  ascribed  to  syncope. 

The  fatal  dose  is  undetermined,  in  consequence  of  the 
diversity  in  the  strength  of  the  different  preparations  of 
the  drug.  The  medicinal  preparations  are  the  tinctures  of 
the  leaves  and  root,  and  the  alcoholic  extract.  The  latter  is 
apt  to  be  inert.  The  tincture  of  the  root  is  the  strongest, 
and  most  reliable.     Twenty-five  drops  of  this  preparation 


392  TOXICOLOGY. 

have  proved  fatal.  An  excise  officer  in  England  died  in  a 
few  hours  after  merely  tasting  Fleming's  strong  tincture. 
Pereira  speaks  of  a  case  where  two  doses  of  six  drops 
each,  taken  at  an  interval  of  two  hours,  produced  most 
alarming  symptoms  in  a  young  man;  and  Wormley  alludes 
to  an  instance  in  which  five  drops  of  Thayer's  fluid  extract 
of  the  root  produced  most  serious  effects,  which  continued 
for  two  hours.  Half  a  drachm  to  a  drachm  may  be  con- 
sidered a  fatal  dose. 

The  symptoms  may  come  on  almost  immediately,  or  be 
delayed  for  an  hour  or  two.  Death  generally  occurs  within 
three  or  four  hours ;  but  it  may  be  deferred,  as  in  other 
poisons,  for  twenty-four  hours. 

Aconitia  (Acomtine), — The  active  alkaloid  principle, 
abounding  most  in  the  root,  of  which  it  constitutes  about 
one-tenth,  to  one-fifth  of  one  per  cent.  In  its  pure  state,  it  is 
probably  the  most  powerful  poison  known.  Pereira  states 
that  one-fiftieth  of  a  grai)i  nearly  proved  fatal  to  an  elderly 
lady.  Much  of  the  aconitia,  as  sold  in  the  shops,  is  totally 
inert  and  worthless.  The  only  reliable  article  is  that  of 
Morson,  of  London,  and  probably  some  of  the  German 
manufacture.  One-tenth  of  a  grain  may  be  considered  a 
fatal  dose.  This  poison  has  lately  been  brought  promi- 
nently into  notice  in  the  case  of  Dr.  Lamson,  who  used  it  in 
destroying  his  brother-in-law,  in  England,  about  a  year  ago. 

Treatment. — There  is  no  chemical  antidote.  The  stomach 
should  be  immediately  emptied  by  the  stomach-pump,  or  an 
active  emetic.  Animal  charcoal  is  recommended  by  Head- 
land, also  tannin,  or  astringent  infusions.  Slight  galvanic 
shocks  are  recommended  to  be  passed  through  the  heart,  in 
order  to  arouse  its  action,  also  the  employment  of  artificial 
respiration.  Possibly,  the  inhalation  of  oxygen  might  be  of 
some  advantage. 


POISONING    BY   ACONITIA TESTS.  393 

As  strychnia  and  aconitia  appear  to  be  mutually  antago- 
nistic, it  might  be  well  to  employ  the  former,  cautiously,  in 
the  treatment  of  poisoning  by  the  latter.  A  case  of  a  child 
is  quoted,  from  Am.  Jour.  Med.  Set.,  January,  1862,  in  which 
the  recoveiy  was  apparently  due  to  two  doses  of  tincture 
of  nux  vomica,  administered  twenty  minutes  apart. 

It  would  also  appear  that  digitalis  possesses  an  antidotal 
power  over  aconitia.  Dr.  J.  M.  Fothergill  discovered  that 
digitalis  administered  to  frogs  that  were  under  the  influence 
of  aconite  .relieved  the  heart  from  the  depression  produced 
by  the  latter  poison,  recalling  its  normal  movements.  A 
case  is  reported,  in  the  Brit.  Med.  Journal,  December,  1872, 
where  recovery  took  place  in  a  man  who,  when  intoxicated, 
had  swallowed  an  ounce  of  Fleming's  tincture.  The  patient 
was  apparently  dying,  when  twenty  minims  of  tincture  of 
digitalis  were  injected  subcutaneously,  and  after  twenty 
minutes  the  patient  had  recovered  sufficiently  to  swallow, 
when  a  fluid  drachm  of  the  tincture  was  given,  along  with 
brandy  and  ammonia,  and  was  twice  repeated  within  an 
hour.  The  above  statement  certainly  warrants  the  employ- 
ment of  this  remedy  in  a  case  of  aconite-poisoning. 

Chemical  analysis. — Aconitia,  when  pure,  is  in  colorless, 
transparent  crystals.  Taste,  at  first,  acrid,  soon  followed  by 
tingling,  and  numbness  of  the  lips  and  tongue.  Its  solution, 
applied  to  the  skin,  occasions  a  feeling  of  heat  and  numb- 
ness. So  active  is  this  poison  that,  according  to  Stevenson, 
one  two-thousandth  of  a  grain  of  Morson's  aconitine  will 
destroy  a  mouse.  This  same  quantity  causes  tingling  and 
numbness  of  the  lips  and  tongue,  when  applied  to  the  tip 
of  the  latter  organ ;  and  one-hundredth  of  a  grain,  dissolved 
in  spirit  and  rubbed  into  the  skin,  causes  a  loss  of  feeling, 
lasting  for  some  time. 

It  has  strong  basic  properties,  forming  salts  with  acids, 
18 


394  TOXICOLOGY. 

which  are  mostly  soluble.  It  is  very  slightly  soluble  in 
water,  quite  soluble  in  alcohol  and  chloroform,  but  in- 
soluble in  ether.  None  of  the  mineral  acids  change  it  in 
the  cold,  but  warm  sulphuric  acid  imparts  to  it  a  brown  tint. 
There  is  no  characteristic  chemical  test  for  it.  Its  presence, 
in  a  medico-legal  case,  can  only  be  satisfactorily  established 
by  the  physiological  test — the  peculiar  tingling,  benumbing 
sensation  imparted  to  the  mouth  and  tongue  when  a  minute 
fragment  of  the  ultimate  extract  is  tasted,  or  by  a  similar 
application  to  the  skin,  attended  with  similar  results;  to- 
gether with  its  introduction  into  some  small  animal,  hypo- 
dermically. 

If  the  poisoning  has  occurred  from  swallowing  the  leaves 
or  root  of  the  plant,  a  careful  microscopic  inspection  of  the 
stomach  and  bowels,  and  of  the  matters  vomited  and  purged, 
should  be  instituted,  in  order  to  identify  their  botanical 
characters. 

Toxicological  examination. — A  modification  of  Stas'  pro- 
cess should  be  employed,  similar  to  that  described  for  nico- 
tine (p.  384).  Chloroform  is  preferable  as  the  ultimate  sol- 
vent. The  residue  thus  obtained  should  be  dissolved  in  a 
few  drops  of  pure  water,  slightly  acidified  with  acetic  acid, 
and  submitted  to  the  physiological  tests  above  described. 
If  these  afford  no  satisfactory  results,  no  mere  chemical 
tests  can  be  relied  on;  but  if  they  give  evidence  of  the 
presence  of  the  poison,  then  the  solution  should  be  sub- 
jected to  all  the  known  reactions,  such  as  carbazotic  add, 
bichloride  of  platinum,  chloride  of  gold,  and  the  bromine  test. 

Calabar  Bean. — The  Ordeal  Bean  of  Calabar  (Physos- 
tigma  venosum)  is  a  large  leguminous  seed,  from  an  inch 
to  an  inch  and  a  half  long,  of  a  brownish-black  color.  It  is 
used  by  the  natives  of  the  West  Coast  of  Africa  as   the 


POISONING    BY    CALABAR    BEAN ANTIDOTE.  395 

ordeal  test  for  witchcraft — the  suspected  person  being  com- 
pelled to  drink  a  decoction  of  the  poisonous  beans.  It  owes 
its  activity  to  the  alkaloid  physostigmia,  also  named  eserine, 
which  resides  in  the  cotyledons.  These,  when  touched  with 
nitric  acid,  assume  an  orange  tint,  and  with  perchloride  of 
iron,  a  brown  one.  The  alkaloid  is  a  colorless,  crystalline 
solid,  bitter  to  the  taste,  very  slightly  soluble  in  water  ; 
soluble  in  alcohol,  ether,  chloroform  and  benzol. 

Bromine  in  bromide  of  potassium  produces  with  it  a  red 
color.  It  gives  this  color  with  less  than  tsW  of  a  grain 
(Dragendorff).  According  to  Dr.  J.  B.  Edwards  (Med. 
Times  and  Gaz.,  1864),  it  reacts  with  sulphuric  acid  and  bi- 
chromate of  potassium  very  much  like  strychnia — producing 
the  play  of  colors;  this,  however,  needs  further  confirma- 
tion. 

The  action  of  this  poison  upon  the  lower  animals  is  that  of 
a  spinal  depressant,  causing,  at  first,  tremors,  and  then 
paralysis,  with  muscular  flaccidity;  contraction  of  the 
pupils ;  respiration  slow,  irregular  and  stertorous  ;  some- 
times there  are  convulsions.  The  heart  is  found  to  beat 
for  some  time  after  death.  Consciousness  is  preserved 
throughout. 

The  effects  on  man  are  similar  to  the  above.  They  are 
the  opposite  to  those  produced  by  strychnia,  which  is  a  true 
spinal  excitant.  For  this  reason  it  has  been  employed  as  a 
remedy  for  tetanus,  and  also  as  an  antidote  for  strychnia. 

Its  most  characteristic  physiological  action  is  the  property 
of  contracting  the  pupil,  which  at  once  distinguishes  it  from 
belladonna,  as  also  from  conia  and  curarin,  which  it 
resembles  in  some  particulars. 

The  true  physiological  antidote  is  atropia,  used  hypoder- 
mically,  and  repeated  until  expansion  of  the  pupil  is  mani- 
fested.    From  the  experiments  of  Dr.  Fraser   and  others, 


396  TOXICOLOGY. 

there  can  be  no  doubt  of  the  mutual  antagonism  of  atropia 
and  eserine. 

The  most  satisfactory  test  is  the  physiological  one — its 
power  to  contract  the  pupil.  A  drop  or  two  of  the  suspected 
fluid  is  put  into  the  eye  of  a  rabbit,  or  other  small  animal, 
and  in  the  course  of  fifteen  or  twenty  minutes  the  charac- 
teristic impression  will  be  observed. 

Dragendorff  has  succeeded  in  separating  it  from  the 
tissues  by  a  modification  of  Stas'  process,  employing 
benzol,  instead  of  ether,  as  the  ultimate  solvent. 

Six  of  the  beans,  when  eaten,  proved  fatal  to  a  boy,  aged 
six  years  (Lancet,  Aug.  27,  1864). 


POISONING    BY    HYDROCYANIC    ACID.  397 


CHAPTER   XXX. 

(3)  ASTHENICS. 

This  subdivision  of  Cerebro-spinants  comprises  those 
Neurotics  which  destroy  life  by  asthenia,  or  failure  of  the 
heart's  action.  It  is  not  intended  to  assert  that  they  may 
not  prove  fatal  in  some  cases,  in  another  manner,  as  e.  g., 
through  shock,  or  asphyxia.  But  as  the  most  strongly- 
marked  symptoms  are  those  of  heart  failure,  this  name 
answers  sufficiently  well  for  grouping  together  those  neu- 
rotic poisons  that  especially  display  this  property.  The  two 
most  important  members  of  this  group  are  Hydrocyanic 
Acid  and  Digitalis.  Cocculus  Indicus  is  considered  under 
the  same  head,  for  the  sake  of  convenience. 

section  1. 
POISONING  BY  HYDROCYANIC  ACID. 

NATURAL  OCCURRENCE  IN  VEGETABLES.  —  PURE  AND  OFFICINAL 
ACIDS. — SYMPTOMS. — FATAL  PERIOD  AND  DOSE. — TREATMENT.— 
POST-MORTEM  APPEARANCES. — TESTS. — TOXICOLOGICAL  EXAMINA- 
TION.—  CYANIDE  OF  POTASSIUM.  —  OIL  OF  BITTER  ALMONDS. — 
CHERRY-LAUREL  WATER. — N1TRO-BENZOLE. 

Hydrocyanic,  or  Prussic  Acid,  is  one  of  the  most 
energetic  and  rapidly  fatal  poisons  known.  It  occurs  as  a 
natural  product  in  the  bitter  almond,  the  kernels  of  the 
peach,  apricot,  plum  and  cherry,  the  pips  of  apples,  and  the 
flowers  and  leaves  of  the  peach  and  cherry-laurel.  From 
the  latter,  a  very  poisonous  water  {cherry-laurel  water)  is 
distilled.  It  also  exists  in  the  root  of  the  mountain  ash. 
Properly  speaking,  hydrocyanic  acid  does  not  pre-exist  in 


398  TOXICOLOGY. 

these  vegetable  substances,  but  is  the  product  of  the  reaction 
of  water  upon  two  principles  which  they  contain,  viz.,  amyg- 
dalin  and  emulsin,  at  a  certain  temperature. 

Prassic  acid,  in  its  pure,  anhydrous  state,  is  a  compound 
of  cyanogen  and  hydrogen,  HCy.  It  is  a  colorless,  limpid 
liquid,  extremely  volatile,  and  having  the  odor  of  bitter 
almonds.  It  is  one  of  the  most  active  and  rapidly  fatal 
poisons  known.  A  single  drop  placed  upon  the  tongue  of 
a  large  dog  caused  death  in  a  few  seconds.  The  anhydrous 
acid  is  rarely  met  with  except  in  the  laboratory  of  the 
chemist.  It  possesses  no  medico-legal  interest.  It  is  the 
dilute  or  medicinal  acid  that  is  so  frequently  the  cause  of 
death.  This  latter  is  merely  a  solution  of  the  anhydrous 
acid  in  water. 

It  occurs  in  the  shops  under  two  different  forms :  (i)  The 
officinal  acid,  of  the  average  strength  of  two  per  cent. ;  and 
(2)  Scheeles  acid,  of  the  average  strength  of  five  per  cent. 
But  the  strength  of  both  varieties  varies  considerably,  and 
it  is  not  uncommon  to  find  some  specimens  totally  inert. 
This  may  probably  arise  from  the  liability  of  the  acid  to 
undergo  decomposition  when  exposed  to  the  light.  The 
dilute  acid  is  colorless,  and  has  the  odor  of  bitter  almonds, 
and  a  hot,  pungent  taste. 

Symptoms. — These  vary  with  the  size  of  the  dose.  A 
large  dose — half  an  ounce  to  an  ounce  of  the  diluted  acid — 
may  produce  symptoms  in  the  act  of  swallowing,  or  in  a  few 
seconds  after.  They  are  seldom  delayed  beyond  one  or  two 
minutes.  Tardieu  describes  them  as  "  coming  with  lightning- 
like rapidity."  There  is  .an  immediate  loss  of  muscular 
power,  with  giddiness ;  the  person  staggers  and  falls  to  the 
ground  ;  the  respiration  becomes  hurried  and  gasping  ;  the 
pulse  imperceptible;  the  eyes  glassy  and  protruding;  the 
pupils  dilated  and  insensible  to  light;  the  extremities  cold; 


POISONING    BY   PRUSSIC    ACID — FATAL    DOSE.  399 

and  sometimes,  convulsions  occur.  Toward  the  last,  the 
breathing  is  performed  convulsively,  in  sobs.  Sometimes 
the  bladder  and  rectum  are  evacuated  involuntarily.  As 
regards  the  peculiar  cry  or  shriek,  such  as  is  often  heard  in 
animals  poisoned  by  prussic  acid,  the  experience  of  all 
observers  is  against  its  existence  in  the  human  subject.  The 
face  is  livid  or  pallid,  the  jaws  spasmodically  closed  ;  there 
is  frothing  at  the  mouth,  occasionally  bloody ;  often  the 
peculiar  odor  of  the  poison  can  be  detected  in  the  breath  ; 
death  occurs  sometimes  in  a  violent  convulsion;  at  others  it 
is  preceded  by  coma,  with  stertorous  breathing.  This  latter 
symptom  (stertorous  breathing)  is  of  considerable  medico- 
legal importance,  since  it  might  easily  lead  to  a  mistaken 
diagnosis  for  apoplexy. 

Fatal  period. — Death  generally  occurs  within  ten  or  fifteen 
minutes  after  swallowing  the  poison.  Rarely  is  it  protracted 
for  half  an  hour.  One  case  is  recorded  where  an  hour 
supervened.  Insensibility  is  not,  however,  always  imme- 
diate.; instances  are  recorded  of  persons,  after  swallowing 
very  large  and  fatal  doses  of  this  poison,  performing  many 
voluntary  acts,  such  as  walking  into  another  room,  opening 
drawers,  going  down  stairs,  etc. 

The  symptoms  attendant  on  a  large,  but  not  fatal,  dose, 
are  confusion  of  head,  giddiness,  a  sense  of  weight  upon  the 
brain,  great  muscular  debility,  nau'sea,  vomiting  and  possibly 
convulsions,  oppressed  breathing.  Several  days  may  elapse 
before  complete  recovery  takes  place. 

The  external  application  of  this  acid  to  the^  skin, 
especially  if  abraded,  may  occasion  serious,  and  even  fatal 
consequences.  Christison  reports  a  case  where  the  liquid, 
applied  to  a  wound  in  the  hand,  caused  death  in  one 
hour. 

Fatal  quantity. — The   minimum   fatal  dose  for  an  adult 


400  TOXICOLOGY. 

may  be  taken  to  be  about  fifty  minims  of  the  officinal  acid, 
which  is  equivalent  to  nine-tenths  of  a  grain  of  anhydrous 
acid.  The  largest  dose  from  which  there  was  a  recovery 
was  reported  in  the  Lancet  (January  14,  1854),  in  which  one 
drachm  of  Scheele's  acid,  equivalent  to  2.4  grains  of  anhy- 
drous acid,  was  swallowed  by  mistake.  Other  instances  are 
reported  of  recovery  after  taking  doses  equivalent  to  two 
grains,  and  under,  of  the  anhydrous  acid,  in  all  of  which 
prompt  and  vigorous  measures  were  adopted. 

The  inhalation  of  the  vapor  is  exceedingly  dangerous, 
and  has  even  proved  fatal. 

Treatment. — So  rapid  are  the  poisonous  effects  of  hydro- 
cyanic acid  that  there  is  scarcely  any  opportunity  for  the 
employment  of  remedies.  The  cold  affusion,  by  dashing 
cold  water  over  the  face  and  chest,  should  be  at  once 
employed.  This  should  be  followed  by  the  cautious  inha- 
lation of  diluted  ammonia  and  chlorine  vapors,  along  with 
stimulants,  applied  both  internally  and  externally.  As  a 
chemical  antidote,  a  mixture  of  ferrous  and  ferric  sulphates, 
followed  by  a  solution  of  carbonate  of  potassium,  has  been 
proposed;  this  would  produce,  with  hydrocyanic  acid  in  the 
stomach,  Prussian  blue — an  inert  compound.  The  experi- 
ment has  proved  successful  in  animals. 

Post-mortem  appearances. — The  face  is  pale,  or  livid  ;  the 
eyes  often  glistening  and  staring,  with  the  pupils  dilated ; 
the  lips  blue ;  jaws  firmly  set,  with,  at  times,  a  bloody  froth 
issuing  from  the  mouth.  The  blood  is  of  a  dark  blue  color, 
and  fluid.  The  cerebral  vessels  are  congested.  Tardieu 
alludes  to  effusions  of  blood  and  serum  at  the  base  of  the 
brain,  as  an  occasional  occurrence,  which  might  suggest  the 
presence  of  apoplexy,  which,  however,  is  negatived  by  the 
absence  of  hemiplegia,  and  by  the  rapidity  of  the  death. 
There  is  congestion  of  the  lungs  and  liver;  and  the  mucous 


HYDROCYANIC   ACID — TESTS.  401 

membrane   of  the   stomach,  especially  about   the   cardiac 
extremity,  is  apt  to  be  much  reddened. 

The  exhalation  of  the  peculiar  odor  is  one  of  the  most 
important  post-mortem  characters.  This  odor  is  sometimes 
perceived  even  before  the  body  is  opened,  in  recent  cases, 
but  it  is  particularly  noticeable  in  opening  the  abdomen  and 
thorax,  and  even  the  brain,  but  especially  the  stomach.  But 
as  the  poison  is  very  volatile,  it  may  easily  happen  that  the 
odor  will  have  disappeared  in  a  few  hours  or  days,  if  the 
body  has  been  much  exposed.  There  is  a  singular  variation 
in  this  respect  in  different  cases.  Moreover,  the  odor  may 
be  disguised  by  other  more  powerful  smells,  such  as  tobacco, 
mint,  etc.  The  mere  absence  of  odor  is,  therefore,  no  proof 
of  the  non-existence  of  the  poison. 

CJiemical  analysis. — There  are  four  recognized  tests  for 
hydrocyanic  acid,  which  may  be  briefly  designated  as  the 
silver,  iron,  sulphur  and  copper  tests.  The  first  three  are 
characteristic ;  and  they  may  be  applied  to  the  acid  cither 
in  its  form  of  liquid,  or  vapor. 

I.  The  Silver  test. — A  solution  of  hydrocyanic  acid,  or  of 
a  cyanide,  gives  with  a  solution  of  nitrate  of  silver  a  white 
crystalline  precipitate,  distinguishable  from  the  white  chloride, 
as  follows:  (i)  By  its  crystalline  characters  (prisms  or 
needles) ;  the  chloride  is  amorphous.  (2)  Its  sparing  solu- 
bility in  ammonia;  the  chloride  is  very  soluble.  (3)  The 
permanence  of  its  color  when  exposed  to  the  light ;  the 
chloride  becomes  dark-colored.  (4)  Its  solubility  in  boiling 
nitric  acid  ;  the  chloride  is  insoluble.  (5)  When  perfectly 
dried,  and  heated  in  a  small  reduction-tube,  the  cyanide  of 
silver  is  decomposed,  evolving  cyanogen  gas,  which  burns 
with  a  characteristic  roseate  flame.  (6)  By  adding  to  the 
cyanide  of  silver  hydrochlork:  acid  and  persulphate  of  iron, 
Prussian  blue  will  be  formed. 
18* 


402  TOXICOLOGY. 

Another  mode  of  identifying  the  cyanide  of  silver,  re- 
commended by  Orfila  and  Tardieu,  is,  after  thoroughly 
washing  and  drying  it,  to  introduce  it  into  a  small  glass  tube, 
closed  at  one  end,  from  five  to  seven  inches  long,  and  con- 
taining in  its  closed  extremity  a  rather  less  quantity  of  pure 
iodine.  On  heating  this  end  of  the  tube  very  gently,  beau- 
tiful snow-white  crystals  of  iodide  of  cyanogen  are  deposited 
upon  the  cool  portion  of  the  tube.  These  crystals  may  be 
preserved  indefinitely  in  sealed  tubes  ;  and  they  may  be  used 
for  developing  Prussian  blue,  by  dissolving  them  in  a  solution 
of  potassa,  and  adding  a  mixture  of  a  ferrous  and  ferric 
salt. 

The  silver  test  is  particularly  delicate  when  applied  to  the 
acid  in  a  state  of  vapor.  For  this  purpose  the  material  con- 
taining the  suspected  poison  is  put  into  a  beaker,  or  wide- 
mouthed  flask,  and  a  watch  glass  containing  on  its  concave 
surface  a  drop  or  two  of  nitrate  of  silver  solution  is  inverted 
over  the  mouth  of  the  flask,  which  should  be  gently  heated 
by  immersion  in  warm  water.  The  vapor  of  the  acid  im- 
mediately rises,  and  coming  in  contact  with  the  silver  salt, 
forms  a  white,  opaque  spot  of  cyanide  of  silver,  which  can 
easily  be  recognized  by  a  lens,  and  by  the  other  tests  men- 
tioned above.  If,  however,  the  material  should  be  in  a  state 
of  putrefaction,  this  vapor-test  cannot  be  applied,  since  the 
black  sulphide  of  silver  resulting  from  the  sulphuretted 
hydrogen  of  decomposition,  would  completely  obscure  the 
white  cyanide. 

The  silver  vapor-test  is  considered  to  be  the  most  delicate 
of  all  the  tests.  It  is  stated  that  tWoo^  of  a  grain  of  the  acid 
may  thus  be  distinctly  recognized.  Prof.  Guy  {For.  Med., 
p.  575)  mentions  that  a  single  apple  pip,  bruised  and  mois- 
tened with  water,  and  placed  in  a  watch  glass,  over  which 
was  inverted  another  glass  moistened  with  the  silver  solution, 


HYDROCYANIC    ACID — TESTS.  403 

yielded  twenty-two  distinct  reactions — each  spot  exhibiting, 
by  the  microscope,  crystals  of  cyanide  of  silver. 

2.  The  Iron  test. — This  consists  in  adding  to  the  suspected 
solution  a  little  liquor  potassae,  and  then  a  mixture  of  ferrous 
and  ferric  sulphates ;  a  dirty  greenish-blue  precipitate  is 
thrown  down,  which,  on  addition  of  a  few  drops  of  pure  hydro- 
chloric acid,  becomes  clear  Prussian  blue.  If  the  amount  of 
the  poison  be  very  minute,  there  is  no  immediate  precipitate, 
although  the  solution  has  a  blue  (or  at  first,  perhaps,  a 
green)  color;  but  in  time,  a  blue  precipitate  will  subside. 

In  a  medico-legal  case,  where  great  precision  is  necessary, 
if  the  quantity  is  very  small,  it  is  recommended  to  throw 
the  liquid  upon  a  white  paper  filter,  after  adding  the  hydro- 
chloric acid ;  the  blue  deposit  on  the  paper,  after  washing 
with  very  dilute  acid,  will  show  very  distinctly  upon  the 
white  ground  ;  the  paper  when  dried  may  be  preserved  for 
exhibition,  if  needed. 

In  manipulating  with  this  test,  caution  should  be  used  not 
to  employ  an  excess  of  the  reagents,  as  this  materially 
interferes  with  the  success  of  the  experiment. 

The  iron  test  may  also  be  used  as  a  vapor  test.  Moisten 
the  watch  glass  with  a  drop  of  potassa  solution,  and 
after  exposure  to  the  suspected  vapors,  add  a  drop  or  two 
of  the  mixed  iron  salts,  and  develop  the  Prussian  blue  by  a 
drop  of  dilute  hydrochloric  acid. 

3.  The  Sulphur  test  (Liebig's  test). — If  sulphide  of  ammo- 
nium be  added  to  a  solution  of  hydrocyanic  acid,  and  gently 
heated  to  dryness,  a  white  sulpho-cyanide  of  ammonium  is 
formed ;  when  this  is  touched  with  a  drop  of  perchloride, 
or  persulphate,  of  iron,  there  is  instantly  produced  the 
blood-red  sulpho-cyanide  of  iron,  which  is  characteristic  of 
the  presence  of  prussic  acid,  in  the  absence  of  meconic  acid 
{vid.  Opium,  p.  337). 


404  TOXICOLOGY. 

The  sulphur  test  is  best  applied  as  a  vapor  test.  Moisten 
a  watch  glass  with  a  drop  or  two  of  sulphide  of  ammonium, 
and  invert  it  over  the  vessel  containing  the  prussic  acid, 
gently  warming  the  latter,  as  above  directed.  The  vapor 
will  rise,  and  form  the  sulpho-cyanide  of  ammonium  on  the 
glass.  When  this  is  allowed  to  dry  by  evaporation,  it 
appears  as  a  white  spot,  and  when  it  is  touched  with  a  drop 
of  the  iron  salt  it  immediately  assumes  the  characteristic 
blood-red  color.  If  the  evaporation  should  not  have  been 
complete,  so  as  to  thoroughly  dry  it,  the  application  of  the 
iron  salt  may  produce  a  black  stain  (sulphide  of  iron),  which 
will  obscure  the  result. 

The  sulphur  test,  moreover,  may  be  applied  to  confirm 
the  silver  test.  For  this  purpose,  the  spot  of  cyanide  of 
silver  should  be  moistened  with  a  drop  of  sulphide  of  am- 
monium, and,  when  thoroughly  dried,  touched  with  a  drop 
of  the  persalt  of  iron.  The  characteristic  blood-red  color 
may  be  distinguished,  in  spite  of  the  black  sulphide  with 
which  it  is  associated. 

4.  The  Copper  test'. — The  liquid  is  first  made  slightly 
alkaline  by  liquor  potassae,  and  a  dilute  solution  of  sulphate 
of  copper  is  added ;  a  greenish-white  precipitate  is  thrown 
down,  which  becomes  nearly  white  on  the  addition  of  a 
little  hydrochloric  acid. 

This  test  may  be  used,  also,  as  a  vapor  test.  The  watch 
glass  is  moistened  with  a  drop  of  the  copper  solution,  made 
slightly  alkaline,  and,  after  exposure,  a  drop  of  dilute  hydro- 
chloric acid  is  added. 

As  regards  the  relative  delicacy  of  the  above  tests,  experi- 
ments show  that  for  the  liquid  hydrocyanic  acid,  the  iron 
and  sulphur  tests  exceed  the  silver  test;  but,  when  in  the 
form  of  vapor,  the  latter  far  surpasses  all  the  others. 

Toxicological  examination. — The   stomach,  together  with 


PRUSSIC    ACID TOXICOLOGICAL    EXAMINATION.  405 

its  contents,  and  other  viscera  (having  first  been  carefully 
examined  for  the  peculiar  odor)  should  be  distilled  in  a  glass 
retort,  at  a  moderate  temperature,  care  being  first  taken  to 
ascertain  if  the  material  is  acid  or  alkaline.  Unless  distinctly 
alkaline,  no  acid  must  be  added,  otherwise  it  will  be  impos- 
sible to  determine  whether  the  prussic  acid  found  in  the 
distillate  was  originally  present  in  the  free  state,  or  whether 
it  might  not  have  resulted  from  the  action  of  the  acid  used 
upon  a  cyanide,  a  ferrocyanide,  or  a  sulpho-cyanide,  that 
might  have  been  present  in  the  material.  Therefore,  in  a 
medico-legal  case  of  suspected  poisoning  by  prussic  acid, 
we  deem  it  very  unadvisable  to  employ  any  acid  in  the  dis- 
tilling process,  since,  by  so  doing,  the  examiner  puts  it  out 
of  his  power  to  determine  whether  the  poison  was  really 
present  in  the  free  state,  or  whether  he  may  not  have  actually 
manufactured  it  out  of  the  sulpho-cyanide  of  potassium, 
which  is  known  to  exist  in  human  saliva,  and  which  would 
be  very  likely  to  be  present  in  the  stomach  of  the  deceased. 
Of  course,  if  cyanide  of  potassium  has  been  the  poison 
employed,  the  contents  of  the  stomach  would  give  an  alka- 
line reaction,  in  which  case  the  addition  of  sulphuric,  or 
some  other  acid,  would  be  perfectly  proper. 

In  the  celebrated  case  of  Dr.  Paul  Schceppe,  in  Carlisle, 
Pa.,  in  1868  and  1872,  this  was  made  a  capital  point  by  the 
defence.  The  allegation  at  first  had  been  that  the  deceased 
(a  lady  of  fifty-four  years)  had  been  poisoned  by  prussic 
acid.  It  was  afterward  contended  that  the  death  was  due 
to  a  mixture  of  prussic  acid  and  morphia.  The  analyst 
employed  the  distillation  process,  along  with  sulphuric  acid, 
and  testified  to  his  having  only  obtained  faint  traces  of 
prussic  acid  by  his  process.  It  was  very  justly  contended 
by  the  defence  that  these  "  traces  "  of  the  poison  could 
readily  be  accounted  for  by  the  faulty  process  employed  in 


4  OB  TOXICOLOGY. 

the  analysis,  being,  in  fact,  the  result  of  the  action  of  the 
acid  upon  the  sulpho-cyanide  of  potassium  which  is  often 
found  in  the  saliva.  Moreover,  there  was  an  entire  absence 
of  the  characteristic  symptoms  of  the  alleged  poison  before 
death.  At  the  second  trial,  the  evidence  of  the  prosecution 
completely  broke  down,  and  the  prisoner  was  acquitted. 

The  source  of  the  poison  found  in  the  distillate,  where  an 
acid  is  employed,  may  be  determined  by  treating  a  portion 
of  the  original  material  with  a  few  drops  of  hydrochloric 
acid,  stirring  the  mixture  for  a  short  time,  and  adding  the 
perchloride  of  iron.  If  the  liquid  contains  either  a  ferro- 
cyanide,  or  a  sulpho-cyanide,  the  former  will  be  indicated 
by  the  formation  of  Prussian  blue,  and  the  latter  by  the  red 
sulpho-cyanide  of  iron ;  whereas,  a  simple  cyanide,  as  cya- 
nide of  potassium,  will  not  give  any  reaction  under  the 
circumstances. 

As  regards  the  question  whether  prussic  acid  can  be 
generated  spontaneously,  by  the  distillation  of  putrescent 
animal  matters,  although  Orfila  appears  to  have  inclined  to 
this  belief,  it  is  not  held  by  later  authorities.  Still,  we  are 
of  the  opinion  that,  in  an  important  medico-legal  case,  in- 
volving the  life  of  the  accused,  something  more  should  be 
insisted  on  as  proof  of  poisoning  than  the  finding  of  "mere 
traces  "  of  prussic  acid,  since  these  might  possibly  be  the 
result  of  some  spontaneous  animal  decomposition,  brought 
about  under  conditions  not  yet  perfectly  understood.  Espe- 
cially should  this  be  insisted  on,  where  the  symptoms  pre- 
ceding death  did  not  agree  with  those  characteristic  of  the 
alleged  poison  {vid.t  Ptomaine \r,  post). 

Period  after  death  when  the  poison  may  be  found. — On 
account  of  its  volatility  and  ready  decomposition,  all  traces 
of  prussic  acid  may  disappear  very  shortly  after  death.  The 
most  skillful  analysts  have  failed  to  discover  it  in  twenty-six 


POISONING    BY    CYANIDE    OF    POTASSIUM.  407 

hours  after  death,  in  some  cases;  whilst  in  others  it  has 
been  detected  as  late  as  twenty-three  days  after. 

The  mere  fact  of  putrefaction  is  no  obstacle  to  its  detec- 
tion, although  in  such  a  case  it  will  not  be  discoverable, 
either  by  distillation,  or  by  the  vapor  tests.  It  would  have 
all  been  converted  into  sulpho-cyanide  of  ammonium  by 
the  sulphide  of  ammonium  resulting  from  the  putrefaction. 
In  such  a  case,  the  material  should  be  rendered  slightly 
alkaline,  and  then  acted  on  by  alcohol,  which  dissolves  the 
sulpho-cyanide ;  filter,  and  evaporate  to  dryness ;  dissolve 
the  residue  in  water,  and  test  by  a  persalt  of  iron. 

Quantitative  determination. — Free  hydrocyanic  acid  is 
precipitated  'by  nitrate  of  silver  ;  the  resulting  cyanide  is 
washed,  dried,  and  weighed.  Every  ioo  parts  represent 
20.15  parts  of  anhydrous  acid. 

Cyanide  of  Potassium. — This  salt  is  very  much  employed 
in  photography  and  electrotyping,  and  is  a  frequent  source 
of  poisoning  to  artisans  engaged  in  the  above  employments. 
It  is  a  powerful  poison,  causing  death  in  doses  under  five 
grains. 

It  is  a  white,  deliquescent  salt,  very  soluble  in  water,  less 
so  in  alcohol,  the  solution  giving  off  the  prussic  odor;  it 
has  an  alkaline  reaction. 

The  symptoms,  post-mortem  lesions  and  treatment  are 
similar  to  those  described  under  Hydrocyanic  Acid. 

Chemical  analysis. —  i.  It  is  decomposed  by  all  acids,  set- 
ting prussic  acid  free,  which  is  readily  recognized.  2.  It 
gives,  with  nitrate  of  silver,  the  white  cyanide  of  silver. 
3.  The  potash  is  precipitated  by  tartaric  acid,  and  bichloride 
of  platinum.  4.  The  iron  and  copper  tests  may  be  used,  as 
for  prussic  acid,  but  withotit  the  liquor  potassae. 

In  organic  mixtures,  the  prussic  acid  may  be  obtained  by 


408  TOXICOLOGY. 

neutralizing  with   sulphuric  acid,  and    distilling   at   a    low 
temperature. 

Oil  of  Bitter  Almonds. — This  does  not  pre-exist  in 
the  bitter  almond,  but  results  from  the  reaction  of  water 
upon  its  amygdalin  and  emulsin.  It  is  obtained  by  distilla- 
tion of  bitter  almonds,  reduced  to  a  pulp,  along  with  water. 
It  contains  a  variable  proportion — seven  to  fourteen  per 
cent. — of  anhydrous  prussic  acid,  together  with  hydrate  of 
benzole,  benzoin  and  benzoic  acid.  When  entirely  freed 
from  prussic  acid,  the  oil  is  innocuous. 

Properties. — It  has  a  light  yellow  color,  pungent,  prussic 
odor,  and  a  bitter,  aromatic,  pungent  taste.  It  is  heavier 
than  water,  in  which  it  is  but  slightly  soluble;  soluble  in 
alcohol  and  ether.  It  is  highly  poisonous.  The  liquid  sold 
as  essence  of  bitter  almonds  is  a  solution  of  this  oil  in  alcohol  ; 
it  is  a  very  dangerous  substance  for  domestic  use. 

The  symptoms,  post-mortem  lesions  and  treatment  are  the 
same  as  those  described  under  the  head  of  Hydrocyanic  Acid. 

The  fatal  dose  is  about  twenty  drops. 

Cherry-Lacrel  Water,  obtained  by  distilling  the  leaves 
of  the  cherry-laurel  (Prunus-lauro  cerasus)  contains  a  por- 
tion of  an  essential  oil  similar  to  the  oil  of  bitter  almonds. 
It  o\Yes  its  poisonous  properties,  like  the  latter,  to  the 
prussic  acid  contained.  Cherry-laurel  water  has  occasion- 
ally proved  fatal.  It  is  specially  identified  with  the  cele- 
brated Donallen  case,  who  poisoned  his  brother-in  law,  Sir 
Theodosius  Broughton,  in  1782. 

The  kernels  of  the  peach,  apricot  and  cherry  have  all 
proved  poisonous,  especially  to  children  who  have  swal- 
lowed them.  The  symptoms  are  very  similar  to  those  pro- 
duced by  a  moderate  dose  of  prussic  acid. 


POISONING    BY    DIGITALIS.  409 

Nitro-Benzole,  or  Essence  of  Mirbane. — This  substance 
is  the  product  of  the  action  of  nitrous  acid  on  benzole.  It 
is  a  pale  yellow  liquid,  with  a  strong  odor  of  bitter  almonds. 
It  is  used  in  perfumery  and  confectionery  as  a  cheap  substi- 
tute for  the  oil  of  bitter  almonds.  It  is  a  powerful  narcotic, 
producing  effects  resembling  those  of  prussic  acid,  although 
much  slower  in  its  operation,  requiring  four  or  five  hours 
before  death  occurs,  which  is  usually  preceded  by  coma,  as 
in  apoplexy.  This  poison  operates  more  rapidly  and  power- 
fully when  inhaled  in  the  form  of  vapor. 

In  a  fatal  case  it  may  be  generally  identified  by  its  strong 
odor. 

Chemical  analysis. — It  is  distinguished  from  the  oil  of 
bitter  almonds,  which  it  so  closely  resembles  in  smell,  by 
pouring  a  few  drops  of  each  upon  a  plate  and  adding  a  drop 
of  strong  sulphuric  acid  ;  the  oil  of  bitter  almonds  acquires 
a  rich  crimson  color,  with  a  yellow  border,  while  the  nitro- 
benzole  is  not  affected.  It  gives  none  of  the  reactions  of 
hydrocyanic  acid  with  the  usual  tests  of  this  acid. 

When  associated  with  organic  substances,  as  the  stomach, 
etc.,  it  may  be  separated  by  first  adding  sulphuric  acid,  and 
distilling. 

SECTION  II. 
POISONING  BY  DIGITALIS.- DIGITALINE. 

SYMPTOMS. — POST-MORTEM  LESIONS. — FATAL  DOSE. — DIGITALINE. — 
CHEMICAL  ANALYSIS. — TOXICOLOGICAL  EXAMINATION. — CASE  OF 
DE   LA   FOMERAIS. 

The  purple  Foxglove  {Digitalis  purpurea}  is  a  native  of 
Europe,  but  cultivated  in  our  gardens.  All  parts  of  the 
plant  contain  the  poisonous,  active  principle,  digit  aline, 
which,  however,  abounds  most  in  the  leaves  of  the  second 
year's  growth. 


410  TOXICOLOGY. 

Symptoms. — Cases  of  digitalis  poisoning  are  comparatively- 
rare.  Until  recently,  its  action  was  generally  regarded  as  a 
direct  cardiac  depressant,  reducing  both  the  force  and  fre- 
quency of  the  heart's  action.  Modern  therapeutists  are  dis- 
posed to  consider  it  as  a  direct  heart  stimulant,  asserting 
that,  while  the  pulsations  of  the  heart  are  diminished  in  fre- 
quency, they  are  increased  in  power. 

The  poisonous  impressions  in  man  are  nausea  and  vomit- 
ing, purging,  with  severe  abdominal  pains,  a  sense  of  heat 
in  the  head,  vertigo  and  disordered  vision,  dilated  pupils,  the 
pulse  full  and  slow  in  the  horizontal  position,  but  rapid  and 
feeble  on  sitting  up.  Prostration  then  comes  on,  with  a  ten- 
dency to  syncope ;  the  eyes  very  prominent  and  'fixed,  the 
sclerotic  coat  acquiring,  according  to  Tardieu,  a  peculiar, 
characteristic  blue  color.  Sometimes  there  is  salivation  and 
suppression  of  urine ;  delirium,  stupor  and  convulsions 
are  apt  to  occur  just  before  death,  which  does  not,  as  a  rule, 
occur  within  twenty-four  hours.  Tardieu  mentions  a  case 
who  died  in  three-quarters  of  an  hour  after  swallowing,  by 
mistake,  a  very  large  dose. 

Digitalis  is  a  cumulative  poison,  showing  a  tendency  to 
break  out  with  great  violence  after  taking  a  number  of 
moderate  doses.  The  most  diagnostic  sign  of  the  action  of 
digitalis  is  the  peculiar  enfeebled,  intermittent  pulse,  which 
varies  so  notably  between  the  supine  and  the  erect  position 
of  the  patient. 

Post-mortem  appearances. — Nothing  very  characteristic. 
Turgescence  of  the  vessels  at  the  base  of  the  brain,  together 
with  redness  of  the  lining  membrane  of  the  stomach. 

Fatal  dose. — Not  accurately  settled.  As  much  as  a  drachm 
of  the  powder,  and  half  a  fluid  ounce  of  the  tincture,  have 
been  taken  with  impunity ;  but  a  far  less  quantity  has  pro- 
duced decided  effects  on  the  heart's  action.    The  usual  dose 


POISONING    BY    DIGITALINE TESTS.  411 

is  one  to  two  grains  of  the  powder,  and  ten  drops  of  the 
tincture,  to  be  repeated. 

Digitaline. — A  neutral  principle,  generally  occurring  as 
an  amorphous  powder,  of  a  pale  yellowish  color ;  sometimes 
in  the  crystalline  state.  There  seems  to  be  much  diversity 
of  opinion  concerning  the  percentage  of  digitaline  in  the 
leaves ;  some  authorities  giving  it  at  about  ten  per  cent., 
whilst  Blaquart  asserts  that  there  are  ten  to  twelve  per  cent, 
of  the  crystodlizable  variety. 

There  seems  to  be  a  true  antagonism  between  digitaline 
and  aconitine.  It  is  stated  that  when  the  heart  of  the  frog 
has  almost  ceased  to  beat,  under  the  influence  of  digitalis, 
its  movements  are  restored  by  aconitine ;  and  a  case  is  re- 
ported {Brit.  Med.  Jour.,  Dec,  1872)  of  recovery  after  the 
ingestion  of  an  ounce  of  Fleming's  tincture  of  aconite,  ap- 
parently due  to  the  hypodermic  injection  of  twenty  minims 
of  tincture  of  digitalis,  and  the  exhibition  by  the  mouth  of 
three  doses  of  one  drachm  each,  within  an  hour,  together 
with  brandy  and  ammonia  (//.  C.  Wood's  Tlierap.,  p.  125). 
As  yet,  no  case  of  digitalis-poisoning  in  man  has  been  re- 
corded, in  which  the  antidotal  virtues  of  aconitine  have  been 
tested. 

Chemical  analysis. — Both  the  amorphous  and  crystalline 
varieties  have  a  very  bitter  taste ;  very  sparingly  soluble  in 
water,  also  in  pure  ether ;  but  very  soluble  in  ether  con- 
taining alcohol.  Chloroform  is  its  best  solvent.  It  has  no 
alkaline  reaction.  Cold  sulphuric  acid  imparts  to  it  a 
brownish  color,  which  gradually  changes  to  a  red.  If 
warmed,  the  color  passes  to  a  brown.  If  to  the  cold  brown 
solution  an  excess  of  water  be  added,  the  color  changes  to 
a  green,  depositing  a  green  powder,  and  the  liquid  gradually 
assumes  a  yellowish  tint(Tardieu).  Strong  nitric  acid  dis- 
solves   it   with    effervescence,    giving   off  red    fumes    and 


412  TOXICOLOGY. 

imparting  an  orange-red  color,  which  gradually  becomes 
fainter.  Hydrochloric  acid  imparts  to  it  a  light-greenish 
tint.  It  is  stated  that  if  the  brown  sulphuric  acid  solution 
be  exposed  to  bromine  vapor,  it  assumes  a  violet  hue,  but 
Tardieu  denies  that  this  test  is  at  all  characteristic. 

Toxicological  examination. — In  a  suspected  case  the  ex- 
aminer should  first  carefully  search  for  remnants  of  the 
powdered  leaves  in  the  matters  vomited,  and  in  the  ali- 
mentary canal.  If  the  tincture  has  been  swallowed,  the 
interior  of  the  stomach  might  present  a  greenish  color  and 
emit  a  suggestive  odor.  If  digitaline  granules  have  been 
taken,  a  careful  post-mortem  inspection  might  possibly  reveal 
the  presence  of  some  of  them  remaining  in  the  stomach. 

The  viscera,  properly  comminuted,  should  first  be  heated 
on  a  water-bath,  with  strong  alcohol,  for  a  considerable  time. 
After  cooling  and  straining,  and  proper  concentration  by 
evaporation,  part  of  the  extract  may  be  used  as  a  trial  test 
on  a  small  animal.  The  rest  of  it  should  be  further  purified 
by  another  solution  in  alcohol,  filtration  and  evaporation, 
and  the  physiological  test  again  repeated. 

All  authorities  unite  in  saying  that,  in  a  medico-legal 
case,  it  is  impossible  to  determine  the  existence  of  the 
poison  by  any  chemical  tests,  neither  by  the  post-mortem 
lesions ;  our  reliance  must  be  solely  on  the  physiological 
test — injecting  hypodermically  some  of  the  ultimate  extract 
into  a  small  animal,  as  the  frog.  It  seems  well  established, 
by  numerous  experiments,  that  death  takes  place  by  a 
sudden  cessation  of  the  heart's  action,  with  a  decided 
rigidity  of  the  ventricles  at  the  moment  of  death.  In  frogs, 
this  stoppage  occurs  always  in  the  state  of  strong  systole  of 
the  ventricle. 

By  observing,  then,  the  action  of  the  suspected  poison, 
introduced  under  the  skin  of  the  frog,  the  gradual  irregu- 


POISONING    BY    COCCULUS    INDICUS.  413 

larity  and  slowness  of  the  heart-beats,  together  with  the 
manner  of  its  final  stop,  and  experimenting  at  the  same 
time,  with  digitaline  itself,  upon  another  animal,  we  may  be 
able  to  arrive  at  a  satisfactory  conclusion. 

The  most  noted,  if  not  the  only,  instance  of  homicidal 
poisoning  by  digitaline  is  that  of  de  la  Pomerais,  a  homceo- 
pathic  practitioner  of  France,  who  was  tried  and  convicted 
for  killing  his  former  mistress,  after  having  insured  her  life 
in  various  offices  for  his  own  benefit.  After  one  of  his 
visits  to  her  she  died,  after  suffering  from  violent  vomiting 
and  great  depression  of  the  heart's  action  and  debility,  in 
twenty-four  hours.  Her  body  was  examined  thirteen  days 
after  death,  suspicion  having  been  aroused  against  the 
prisoner.  The  examiners,  Tardieu  and  Roussin,  failing  to 
discover  any  poison  by  chemical  research,  resorted  to  the 
above-mentioned  physiological  test,  employing  the  extract 
obtained  from  the  stomach  and  bowels  and  one  procured 
from  the  scrapings  of  the  floor  on  which  the  deceased  had 
vomited,  which  responded  also  to  all  the  known  chemical 
reactions.  A  strong  circumstantial  evidence  of  the  guilt  of 
the  accused  was  the  finding  in  his  possession  an  unusually 
large  amount  of  digitaline — a  substance  that  had  only  lately 
been  discovered,  besides  a  number  of  other  deadly  poisons. 
In  short,  he  had  the  motive,  the  means  and  the  opportunity 
for  accomplishing  his  purpose.  He  was  condemned  and 
executed  (Tardieu,  Sur  /'  Empoison.,  p.  694). 

Poisoning  by  Cocculus  Indicus. — Cocculus  Indicus 
{Levant  nut)  is  the  fruit  of  the  Anamirta  cocculus,  a  tree 
growing  in  the  East  Indies.  The  kernel  of  the  berry  is  the 
only  poisonous  part.  It  has  an  intensely  bitter  taste,  and 
contains  a  highly  poisonous  principle  called  Picrotoxine.  It 
is    chiefly  employed  as   a  fish  poison,  and  also  in   Great 


414  TOXICOLOGY. 

Britain  for  the  malicious  destruction  of  game.  It  is  also 
popularly  believed  to  be  used  for  adulterating  malt  liquors, 
by  imparting  to  them  a  bitter  flavor,  with  a  diminished 
amount  of  hops  and  malt.  It  is  also  used  for  the  destruc- 
tion of  vermin. 

The  symptoms  are  somewhat  singular,  indicating  an  action 
on  the  cerebro-spinal  centres.  There  is  loss  of  voluntary 
power,  but  not  of  consciousness,  the  sufferer  lying  in  a  sort 
of  nightmare.  There  may  also  be  nausea,  vomiting  and 
severe  abdominal  pains.  The  late  Dr.  Fish,  of  Philadelphia, 
reported  several  cases  of  accidental  poisoning  by  a  decoction 
of  this  substance,  of  six  persons  in  the  Philadelphia  Hos- 
pital. Two  of  these  died  in  about  half  an  hour.  The 
remaining  four  were  seized  with  violent  symptoms  within 
half  an  hour  after  swallowing  the  poison,  and  recovered 
after  several  hours.  Their  symptoms  were  faintness,  con- 
fusion of  mind,  giddiness,  dimness  of  vision,  nausea,  ex- 
cessive thirst,  severe  abdominal  pain,  and  in  one  case, 
insensibility.  The  pulse  was  much  weakened  and  the 
respiration  slow  and  labored. 

The  external  application  has  been  followed  by  violent  and 
even  fatal  effects. 

Picrotoxine,  or  picrotoxia  is  generally  regarded  as  an  alka- 
loid. It  constitutes  about  one  per  cent,  of  the  kernel.  It 
crystallizes  in  colorless,  silken,  slender,  six-sided  prisms. 
Sparingly  soluble  in  water,  very  soluble  in  alcohol,  ether, 
chloroform  and  amylic  alcohol.  Cold  sulphuric  acid  does 
not  affect  it ;  the  hot  acid  imparts  to  it  an  orange-yellow 
color,  which  becomes  pale  on  cooling.  Strong  nitric  and 
hydrochloric  acid  do  not  affect  it.  It  acts  like  grape  sugar 
when  boiled  with  sulphate  of  copper  and  potassa,  and  is  said 
to  belong  to  the  glucosides. 

It  may  be  separated  from  organic  liquids,  such  as  beer, 


POISONING    BY    CYTISINE,    ETC.  415 

or  ale,  by  first  acidulating  with  hydrochloric  acid,  and  then 
shaking  up  with  ether,  which  holds  the  poison  in  solution, 
and  deposits  it  in  crystals.  By  this  same  means  it  may  be 
separated  from  the  stomach,  in  case  of  poisoning. 

There  are  several  other  vegetable  poisons  of  minor  im- 
portance; among  them  may  be  mentioned  the  bark  and 
seeds  of  the  Laburnum  {Cytisus  laburnum),  a  very  common 
tree  or  shrub  of  Great  Britain.  It  contains  an  active  poi- 
sonous principle,  cytisine,  whose  effects  are  those  of  an 
irritant  narcotic.  Death  has  frequently  resulted  from  taking 
both  the  bark  and  seeds  of  this  plant. 

The  leaves  and  berries  of  the  Yew  (Taxus  baccatd)  act 
powerfully  as  an  acrid,  irritant  narcotic,  even  in  small  quan- 
tities. So,  likewise,  do  the  Privet  (Ligistrum  vulgare) ;  the 
Guelder  Rose  {Viburnum  opulus);  and  the  Holly  {Ilex 
aquifoliuni). 


416  TOXICOLOGY. 


CHAPTER     XXXI. 

THE  ALKALOIDS  OF  PUTREFACTION— PTOMAINES. 

Within  the  past  few  years  the  attention  of  toxicologists 
has  been  called  to  the  existence  of  a  certain  class  of  bodies, 
to  which  Selmi  has  given  the  name  of  Ptomaines,  resulting 
from  the  decay  of  organic  substances — chiefly  animal. 
These  bodies  strongly  resemble  the  vegetable  alkaloids  in 
their  chemical  and  physiological  actions.  Some  of  them  are 
very  poisonous,  some  are  inert,  and  others  again  seem  to  act 
antagonistically  to  certain  poisonous  alkaloids. 

There  is,  as  yet,  considerable  uncertainty  and  vagueness 
about  these  bodies,  so  that  we  are  not  qualified  to  speak 
positively  concerning  them.  It  has  long  been  known  that 
putrescent  meat  will  occasion  severe,  and  sometimes  fatal 
symptoms  in  persons  who  partake  of  it.  These  symptoms 
are  of  a  narcotic-irritant  character,  and  strongly  resemble 
those  produced  by  certain  familiar  poisons.  Similar  effects 
are  also  known  to  occasionally  result  from  cheese,  sausages 
and  certain  shell-fish,  particularly  from  mussels  {yid.  ante, 
p.  328);  and,  in  some  instances,  from  canned  vegetables. 
These  anomalous  symptoms  have  been  attributed  to  various 
causes,  but  hitherto  no  very  satisfactory  explanation  of  them 
has  ever  been  offered.  If  the  existence  of  the  cadaveric 
alkaloids,  or  ptomaines,  should  be  positively  demonstrated, 
the  natural  inference  would  then  be  that  these  were  the  true 
cause  of  the  morbific  symptoms  above  alluded  to. 

It  has  been  further  stated  that  decomposed  maize  con- 
tains a  poisonous  alkaloidal  principle,  which  is  capable  of 
producing   tetanic    symptoms,   and   which    are    sometimes 


PTOMAINES.  417 

attended  with  narcosis ;  and  Ranke  contends  that  the 
proper  physiological  action  of  the  impure  strychnia  ex- 
tracted from  a  putrefied  body,  may  be  masked  by  ptomaines. 
If  this  observation  is  correct,  the  fact  may  serve  as  a  very 
plausible  explanation  of  the  occasional  failure  to  discover 
strychnia  and  other  alkaloids  in  a  putrescent  body.  A  con- 
venient process  for  obtaining  these  bodies,  according  to  H. 
Maas  (Am.  Jour.  Med.  Sci.,  July,  1884,  from  Gaz.  Hebdom), 
is  to  treat  the  putrefied  mass  with  alcohol  and  acetic  acid 
for  several  days;  filter,  and  repeat  the  process.  Reduce 
the  alcoholic  extract  on  a  water-bath,  and  concentrate  the 
aqueous  extract  to  a  syrup.  This  may  be  employed  for 
experimentation  on  animals.  By  treating  this  acid  solution 
with  ether,  or  amylic  alcohol,  or  chloroform  (first  adding 
soda),  several  different  alkaloids  have  been  separated,  which 
exhibit  different  physiological  effects  on  frogs — one  acting 
like  morphia,  another  like  strychnia,  and  a  third  paralyzing 
the  heart  and  decomposing  the  blood. 

Some  ptomaines  strongly  resemble,  in  their  properties 
and  effects,  the  alkaloid  aconitine  ;  others  act  very  similarly 
to  veratrum,  morphia  and  codeia;  and  they  might  easily  be 
confounded  with  them  in  a  medico-legal  investigation. 
Methods  of  discriminating  between  them  have,  however, 
been  devised,  in  the  use  of  potassium  ferricyanide  and 
silver  bromide,  as  reagents,  the  former  being  reduced  to  the 
ferrocyanide  in  the  presence  of  a  ptomaine ;  while  no  such 
reduction  occurs  if  an  alkaloid  is  present.  Selmi  and  others 
have  succeeded  in  extracting  poisonous  bases  from  the  urine 
of  patients  suffering  from  tetanus,  progressive  paralysis  and 
miliary  fever;  one  of  these  resembled  nicotina  in  its  general 
character,  showing  a  special  tendency  to  act  upon  the  spinal 
marrow  and  heart ;  the  other  base  resembled  conia  in  odor. 

Still  later  researches  go  to  prove  that  animal  fluids,  such 
!9 


418  TOXICOLOGY. 

as  fresh  blood  and  albumen,  before  undergoing  putrefactio 
give  precisely  similar  reactions,  with  the  reagents  employe 
to  those  that  are  afforded  by  these  same  reagents  wit 
ptomaines  extracted  from  a  dead  animal  body. 

It  will  be  inferred  from  all  that  has  been  stated  about  tl 
so-called  ptomaines,  that  the  whole  matter  may  be  regarde 
as  being  still  sub  judice  ;  and  in  the  language  of  Dr.  Stevei 
son  (from  whose  article  in  Taylor  s  Prin.  and  Prac.  of  Me, 
Jurisp.,  1883,  much  of  the  above  is  taken),  "  the  existence  < 
poisonous  cadaveric  alkaloids  in  human  viscera,  even  whe 
putrid  and  diseased,  is,  to  say  the  least,  very  rare."  Neve 
theless,  it  cannot  be  doubted  that  their  alleged  existence  wi 
be  constantly  employed  by  counsel  in  defending  a  crimin, 
charged  with  poisoning  with  one  of  the  vegetable  alkaloid.1 
urging  strongly  before  the  jury  the  possibility  that  tl 
alleged  poisonous  alkaloid  was  in  reality  one  of  these  spoi 
taneously  generated  ptomaines.  Such  a  course  is  stated  t 
have  been  actually  taken  at  the  late  Lamson  trial,  whic 
occurred  in  London,  in  1883. 


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